title: Dieulafoy's vascular malformation of the jejunum: first case report of laparoscopic treatment.
abstract: A case of Dieulafoy's vascular malformation of the jejunum treated by laparoscopic surgery is described. The patient was a 31-year-old-woman who had complained of melena and had severe anemia needing blood transfusion. Angiography revealed microaneurysms and hypervascularity of the jejunum in the area between the first and second jejunal arterial fields. Laparoscopic partial resection of the jejunum was performed. The resected specimen was histologically diagnosed as Dieulafoy's vascular malformation. Since the operation, the patient has been free of melena and anemia. Small-intestinal Dieulafoy's vascular malformation is rare, as only 41 cases have been reported during the past three decades. Almost two-thirds of the patients were under 40 years old. Most of the patients complained of melena. The lesion was preoperatively identified in 14 of the 41 patients, while angiography was useful to define the lesion. Thirty-six of 37 patients for whom treatment methods were reported were surgically treated. While there are various treatment methods for intestinal bleeding, a surgical operation is often needed. When the disease location is obvious, treatment with laparoscopic surgery can reliably produce good results, in terms of its rate of cure, minimal invasiveness, and better cosmetic effect.
authors.affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Mino
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Yasutake
authors.initials: Y
authors.lastname: Uchima
authors.forename: Masanao
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakamura
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yukawa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Arakawa
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology; D000792:Angiography / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D007583:Jejunum / Q000098:blood supply* / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008551:Melena / Q000209:etiology; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery