Atlas of Gastroenterological Endoscopy
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Dieulafoy ulcer
Dieulafoy- hemorrhage Dieulafoy- hemorrhage This massive vessel with active bleeding was diagnosed in a 58 year- old patient, who presented with tary stools. The first picture shows the lesion after injection of fibrin glue. The right picture shows additionally applied hemoclips. Bleeding stopped at the end of the procedure, but reccurred twice before the patient had to be treated surgically. In dieu-la-foy ulcers an arterial vessel of abnormal size reaches the mucosa causing a tiny ulzeration by permanent compression of the mucosal layer.
At the time perforation takes place the vessel reaches the lumen. Dieu-la-foy hemorrhages are difficult to treat, recurrent bleeding is frequent.