Uremic Bleeding in 2 Patients with Dieulafoy’s Lesion: Case Report and Literature Review  

作　　者：Gustavo Adolfo Hernández Valdez Diana Estefanía Ibarra García Juan Antonio Contreras Escamilla Janette Alejandra Gamiño Gutierrez Francisco Manuel Tonatiuh Carrillo Beltran Ulises Solis Gomez Jocelyn Nataly Quintero Meléndez Ivan Alejandro Medina Jimenez Marco Antonio González Villar Jorge Rojas Morales Gustavo Adolfo Hernández Valdez;Diana Estefanía Ibarra García;Juan Antonio Contreras Escamilla;Janette Alejandra Gamiño Gutierrez;Francisco Manuel Tonatiuh Carrillo Beltran;Ulises Solis Gomez;Jocelyn Nataly Quintero Meléndez;Ivan Alejandro Medina Jimenez;Marco Antonio González Villar;Jorge Rojas Morales(Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico;Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mé,xico)

机构地区：[1]Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico [2]Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mé,xico

出　　处：《Open Journal of Gastroenterology》2024年第5期167-173,共7页肠胃病学期刊（英文）

摘　　要：Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.

关 键 词：Dieulafoy’s Lesion Gastrointestinal Bleeding ENDOSCOPY ENDOSCOPY Hemostatic Clips Kidney Disease ADRENALINE Thermal Coagulation DIEULAFOY 

分 类 号：R57[医药卫生—消化系统]