A case of Dieulafoy-ulcer on the gerater curvature of the gastric fornix

Abstract

A 78-years-old woman was admitted to our hospital because of massive hematoemesis and clouding of consciousness.The emergency endoscopic examination revealed a huge coagulated mass in the stomach, but the orogin of bleeding was not detected. So over-tube was inserted and hood was attached on the tip of the endoscope for the purpose of removing the coagulated mass. Then a small red spot was detected on the greater curvature of the fornix and was found to be Dieulafoy-ulcer. Clipping and epinephrine injection was performed for hematostasis. Endoscopic Examinations 3 and 10 days later revealed no breeding and no vessel. We confirm that seemingly obscure origins of massive hemorrhage of the upper part of the gastrointestinal tract should increase the suspicion of Dieulafoy-ulcer, prompting careful examination of gastric fundic area and greater curvature.