Background: At present, minimally invasive endoscopic treatment is mostly used for patients with actively bleeding Dieulafoy's lesions, , as it has the advantages of minimal trauma, short operation time and good hemostatic effect, although bleeding can easily recur postoperatively. Recently, extensive gastric cuneiform resection has been advocated for use in these patients because the constant-diameter artery follows a long path to the gastric mucosa.
Case Summary: A 47-year-old man was admitted to the hospital for repeated hematemesis and black stool, and he was diagnosed with Dieulafoy's disease. We chose a method that not only simulates surgical gastric cuneiform resection but also reduces trauma. We performed enlarged local endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery and sutured the gastric wall. Postoperative follow-up showed that the constant-diameter artery had been resected from the gastric wall, which was confirmed to have no blood flow signals by endoscopic ultrasonography.
Conclusion: Endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery with suturing of the gastric wall has demonstrated potential as a new treatment for Dieulafoy's disease.
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| http://dx.doi.org/10.3748/wjg.v26.i30.4557 | DOI Listing |
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