TWO CASES OF SUSPECTED EXULCERATIO SIMPLEX (DIEULAFOY): HEMOSTASIS BY ENDOSCOPIC LOCAL INJECTION OF HYPERTONIC SALINE EPINEPHRINE (HS-E) SOLUTION.

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We controlled bleeding from exulceratio simplex (Dieulafoy) in two cases by endoscopic local injection of HS-E solution. Case 1:A 72-year-old man, who had a partial gastrectomy for peptic ulcer 20 years ago, admitted to the hospital with severe anemia. The bleeding continued and we could not find the point of bleeding nevertheless severaltimes of endoscopic examination. At the third week of the admission, we observed a jet of blood from the greater curvature of the remnant stomach. Immediately we injected HSE solution at the point of bleeding and could stop it. Case 2 ; A 59-year-old man admitted to the hospital complaining hematemesis and tarry stool. Re-bleeding was noticed twice after admission. On the 6th hospital day, we found an exposed vessel at the anterior wall of the fornix and injected HS-E solution. We could not detect any peptic ulcer surrounding the exposed vessel, therefore we diagnosed these two cases as exulceratio simplex. It tends to be considered that an operation is the only treatment for the bleeding from exulceratio simplex. However we think that it could be stopped by injecting HS-E solution endoscopically as in our experiences.
社団法人日本消化器内視鏡学会の論文