1992 Volume 53 Issue 3 Pages 634-638
Dieulafoy type ulcer was originally reported as a kind of characteristic ulcers of stomach which can cause massive bleeding. A recent experience with massive jejunal bleeding from tiny ulcer of Dieulafoy type as well as some device identifying the bleeding site intraoperatively is described.
A 39-year-old woman was admitted because of abdominal pain and large amount of melena. Angiography revealed massive bleeding from a peripheral region of the first branch of the jejunal temporarily artery into jejunal lumen. To control the massive bleeding, transarterial embolization (TAE) using metallic coil was performed. Since precise bleeding point was accurately identified during operation by means of radiographic device using metallic coil for TAE as a landmark, only small resection of the jejunal wall was performed. Pathological examination revealed characteristic features of Dieulafoy type ulcer such as small shallow ulcer, rupture of persistent caliber artery, and middle-sized serpentine arteries in the submucosal layer.
