The pathogenesis of Dieulafoy's gastric erosion
Juler, G.L.; Labitzke, H.G.; Lamb, R.; Allen, R.
American Journal of Gastroenterology 79(3): 195-200
1984
ISSN/ISBN: 0002-9270 PMID: 6199971 Document Number: 235384
The solitary gastric erosion of Dieulafoy is rarely recognized but is not an uncommon cause of massive upper gastrointestinal hemorrhage. The English literature has only recently described this lesson in vivo. Its etiology and pathogenesis has remained poorly defined since 1st described in 1896. A series of 9 cases (the largest English literature series), 5 of which were recognized and diagnosed at operation, was recently studied. Multiple tissue staining techniques were used to study the biopsy specimens for clues as to the pathogenesis of this lesion; a vascular dysplasia was suggested which is associated with chronic gastritis, and thrombosis and necrosis of the abnormally tortuous submucosal artery were found to occur before perforation and exigent bleeding. The total lack of inflammatory reaction at the base of the lesion precludes a diagnosis of ulceratio simplex as originally described.