Massive bleeding from Dieulafoy's lesion of the small intestine in a child--therapy for the bleeding from gastrointestinal tract out of endoscopic observation.
Dieulafoy's lesion is recognized as a submucosal artery associated with a minute mucosal defect and a rare cause of severe gastrointestinal hemorrhage. Especially, that of distal jejunum or ileum is extraordinarily rare. It is very difficult to detect the lesion in these parts. We experienced massive bleeding from Dieulafoy's lesion of the distal jejunum in a 12-year-old girl. Preoperative angiography and intraoperative palpation detected the point of bleeding. She was rescued by partial jejunectomy. Compiled reports suggested that careful palpation was useful for detection of the location of the bleeding point, which was enhanced as vascular dilatation by the angiogram, during the operation comparatively.
First Department of Surgery, Kagoshima University School of Medicine, Kagoshima, Japan.
Tetsuhiro
T
Owaki
Chikara
C
Kusano
Masataka
M
Ojiro
Takashi
T
Aikou
D001158:Arteries / Q000473:pathology; D002648:Child; D004108:Dilatation, Pathologic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007579:Jejunal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D007583:Jejunum / Q000098:blood supply; D010173:Palpation