title: Transgastric laparoscopic approach for resection of hemorrhagic Dieulafoy's vascular malformation.
abstract: We report the case of a successfully resected hemorrhagic Dieulafoy's vascular malformation using a transgastric laparoscopic approach. A 37-year-old man was admitted for hematemesis and anemia. Emergency endoscopy revealed active hemorrhage from a submucosal vascular malformation in the posterior gastric wall. Dieulafoy's disease was suspected. It was initially treated by repeated endoscopy. Due to recurrent bleeding, on day 3 the patient was scheduled for surgery. The laparoscopic treatment consisted of an anterior gastrotomy, followed by extirpation and resection of the lesion after evaluation of the gastro-esophageal junction. There was no need for intraoperative endoscopy. To our knowledge, this is the first description of the application of a transgastric laparoscopic approach for the management of a hemorrhagic Dieulafoy's vascular malformation.
authors.affiliation: Department of Surgery, Antoine Béclère Hospital, University of Paris XI, 157 rue de la Porte de Trivaux, 592141 Clamart Cedex, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Proske
authors.forename: C
authors.initials: C
authors.lastname: Vons
mesh_terms: D000328:Adult; D001158:Arteries / Q000002:abnormalities; D001803:Blood Transfusion; D003131:Combined Modality Therapy; D004659:Enbucrilate / Q000627:therapeutic use; D004837:Epinephrine / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D005773:Gastroscopy; D006396:Hematemesis / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D013270:Stomach / Q000098:blood supply* / Q000601:surgery; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D012597:Sclerosing Solutions; D014662:Vasoconstrictor Agents; D004659:Enbucrilate; D004837:Epinephrine