Zusammenfassung
Das Ulcus Dieulafoy ist eine seltene, jedoch mitunter lebensbedrohliche Ursache gastrointestinaler Blutungen. 1898 vom Pariser Chirurgen Georges D. Dieulafoy als Gefäßveränderung im Magen beschrieben, findet sich das Ulcus Dieulafoy zwar in den meisten Fällen im Magen, kann jedoch im gesamten Gastrointestinaltrakt vorkommen und muss bei der Differentialdiagnose gastrointestinaler Blutungen bedacht werden. Therapie der Wahl ist die endoskopische Blutstillung. Nur in Ausnahmefällen ist die operative Therapie als Ultima Ratio unumgänglich. In der vorliegenden Arbeit wird über zwei Patienten mit Dieulafoy-Läsionen des Rektums und unterschiedlichen klinisch-therapeutischen Verläufen berichtet. In beiden Fällen konnte das Ulcus Dieulafoy histologisch verifiziert werden.
Abstract
Dieulafoy’s ulcer is a rare, but potentially life-threatening cause of gastrointestinal bleeding. First described in 1898 by the Paris surgeon Georges D. Dieulafoy as a vascular malformation, the lesion is most commonly found in the stomach, but can occur anywhere within the gastrointestinal tract. Therefore, it must always be taken into consideration for the differential diagnosis of a gastrointestinal hemorrhage. The treatment of choice is endoscopic management of the bleeding. In exceptional cases, however, surgical treatment may sometimes be unavoidable as a last resort. Two patients with a Dieulafoy lesion in the rectum are reported, in whom both clinical course and treatment differed. In each case Dieulafoy’s ulcer was verified histologically.
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Vogel, C., Hansen, H., Fery, K. et al. Ulcus Dieulafoy des Rektums. Coloproctol 31, 219–223 (2009). https://doi.org/10.1007/s00053-009-0026-6
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DOI: https://doi.org/10.1007/s00053-009-0026-6