Published online Aug 14, 2020. doi: 10.3748/wjg.v26.i30.4557
Peer-review started: March 29, 2020
First decision: April 26, 2020
Revised: May 6, 2020
Accepted: July 15, 2020
Article in press: July 15, 2020
Published online: August 14, 2020
At present, minimally invasive endoscopic treatment is mostly used for patients with actively bleeding Dieulafoy’s lesions, , as it has the advantages of minimal trauma, short operation time and good hemostatic effect, although bleeding can easily recur postoperatively. Recently, extensive gastric cuneiform resection has been advocated for use in these patients because the constant-diameter artery follows a long path to the gastric mucosa.
A 47-year-old man was admitted to the hospital for repeated hematemesis and black stool, and he was diagnosed with Dieulafoy’s disease. We chose a method that not only simulates surgical gastric cuneiform resection but also reduces trauma. We performed enlarged local endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery and sutured the gastric wall. Postoperative follow-up showed that the constant-diameter artery had been resected from the gastric wall, which was confirmed to have no blood flow signals by endoscopic ultrasonography.
Endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery with suturing of the gastric wall has demonstrated potential as a new treatment for Dieulafoy's disease.
Core tip: Gastric Dieulafoy’s disease, also known as gastric submucosal constant-diameter arterial malformation, can occur in any part of the digestive tract but is most common in the esophagus and within 6 cm of the gastroesophageal junction. The main symptoms of this disease are recurrent vomiting and tar-like stool. In severe cases, patients can develop hemorrhagic shock, and the mortality rate is high. We performed enlarged local endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery with suturing of the gastric wall. We report a case diagnosed as Dieulafoy’s disease. This is the first case of Dieulafoy's disease treated by this method.