田中孝尚先生の論文が、Clin J Gastroenterol誌にacceptされました。
Clin J Gastroenterol. 2020 Oct 6. doi: 10.1007/s12328-020-01257-7. Online ahead of print.
Gastric Dieulafoy’s lesion with subepithelial lesion-like morphology
Takanao Tanaka, Takeshi Sugaya , Keiichi Tominaga , Mimari Kanazawa , Tsunehiro Suzuki , Mutsumi Ishikawa , Akira Yamamiya , Takahiro Arisaka , Yuichi Majima , Makoto Iijima , Kenichi Goda , Atsushi Irisawa
PMID: 33025344 DOI: 10.1007/s12328-020-01257-7
Most cases of Dieulafoy’s lesion, a rare cause of upper gastrointestinal bleeding, occur in the upper gastric corpus, usually with no edematous bulging or fold convergence around the mucosal defect. This report describes a case of Dieulafoy’s lesion with subepithelial lesion (SEL)-like morphology. Endoscopic treatment by hemoclipping was difficult. Because of repeated bleeding, abdominal dynamic contrast computed tomography (CT) was conducted. Results showed a large caliber, tortuous artery branching directly from the celiac artery and feeding into the gastric wall of the gastric fundus. Rupture of this vessel in the submucosa was thought to be responsible for the SEL-like morphology. All findings indicated endoscopic treatment from the gastric mucosal side was too difficult. Therefore, we treated the lesion using interventional radiology (IR) technique of vascular embolization. If an SEL-like Dieulafoy’s lesion cannot be treated by endoscopic hemostasis, then IR might be necessary to treat the vascular anomaly.
Keywords: Caliber persistent artery; Coil embolization; Dieulafoy’s lesion; Subepithelial lesion.