The Dieulafoy gastric erosion. An infrequently recognized cause of upper gastrointestinal hemorrhage in the elderly. 1990

S A Polit
Department of Internal Medicine, Michael Reese Health Plan, Chicago, Illinois.

Definitive treatment of the Dieulafoy erosion--once recognized--has generally been surgery. Numerous surgical approaches have been suggested, including: simple oversewing of the lesion, wedge restriction, and gastrectomy with and without vagotomy and pyloroplasty. Attempts at endoscopic electrocoagulation and angiographic embolization have generally been disappointing; however, Pointer et al have recently reported satisfactory control of hemorrhage from Dieulafoy lesions with bipolar electrocoagulation and endoscopic injection sclerotherapy, either independently or in combination. These case reports describe two elderly patients with massive upper gastrointestinal tract bleeding from Dieulafoy's gastric erosion; it is hoped the geriatrician will be alerted to an often unrecognized source of hemorrhage.

UI MeSH Term Description Entries
D008297 Male Males
D009336 Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply.
D004547 Elastic Tissue Connective tissue comprised chiefly of elastic fibers. Elastic fibers have two components: ELASTIN and MICROFIBRILS. Elastic Fibers,Elastic Fiber,Elastic Tissues,Fiber, Elastic,Fibers, Elastic,Tissue, Elastic,Tissues, Elastic
D005753 Gastric Mucosa Lining of the STOMACH, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. The surface cells produce MUCUS that protects the stomach from attack by digestive acid and enzymes. When the epithelium invaginates into the LAMINA PROPRIA at various region of the stomach (CARDIA; GASTRIC FUNDUS; and PYLORUS), different tubular gastric glands are formed. These glands consist of cells that secrete mucus, enzymes, HYDROCHLORIC ACID, or hormones. Cardiac Glands,Gastric Glands,Pyloric Glands,Cardiac Gland,Gastric Gland,Gastric Mucosas,Gland, Cardiac,Gland, Gastric,Gland, Pyloric,Glands, Cardiac,Glands, Gastric,Glands, Pyloric,Mucosa, Gastric,Mucosas, Gastric,Pyloric Gland
D005756 Gastritis Inflammation of the GASTRIC MUCOSA, a lesion observed in a number of unrelated disorders. Gastritides
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001165 Arteriovenous Malformations Abnormal formation of blood vessels that shunt arterial blood directly into veins without passing through the CAPILLARIES. They usually are crooked, dilated, and with thick vessel walls. A common type is the congenital arteriovenous fistula. The lack of blood flow and oxygen in the capillaries can lead to tissue damage in the affected areas. Arteriovenous Malformation,Malformation, Arteriovenous,Malformations, Arteriovenous
D012422 Rupture, Spontaneous Tear or break of an organ, vessel or other soft part of the body, occurring in the absence of external force. Ruptures, Spontaneous,Spontaneous Rupture,Spontaneous Ruptures

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