北関東医学
Online ISSN : 1883-6135
Print ISSN : 0023-1908
ISSN-L : 0023-1908
再出血時内視鏡的止血不可能にて手術施行したDieulafoy 潰瘍の1症例
横田 徹荻原 裕之大和 田進藤井 孝尚宮本 幸男斉藤 昭三石井 英昭城下 尚泉雄 勝
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1989 年 39 巻 1 号 p. 99-104

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Since the original report by Dieulafoy, there have been over 200 cases of Dieulafoy's ulcer reported in Japan.
Now we report a case of Dieulafoy's ulcer that necessitated gastrectomy due to unsuccessful endoscopic hemostasis.
A 49-year-old man was admitted to the National Numata Hospital because of sudden hematemesis during having lunch. Successful endoscopic hemostasis was performed by 95% ethanol injection. Three days later, rebleeding occurred, for which endoscopic hemostasis was unsuccessful. Then he got an emergency operation totalgastrectomy and ρ-Roux-en-Y reconstruction.
The resected specimen showed an ulcer measuring 10 × 8 mm with an exposed vessel measuring 2 mm in diameter. Microscopic examination disclosed an abnormally thick vessel in the submucosal layer, which had an inflammatory intima without microaneurysm or arteriolitis.
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