关键词: 胃溃疡, 电凝术, 自然腔道内镜手术

Abstract: Dieulafoy lesion is an uncommon but potentially fatal reason of upper gastrointestinal bleeding. This article reports that a man admitted to one hospital who complained of haematemesis and melena for 4 days. The patient vomited blood twice, with a total amount of about  1 000  ml, accompanied by melena. The gastroscopy indicated a fundus ulcer of about 8 mm in diameter, accompanied by whitish fur and exposed red blood vessels in the center.  The diagnosis was Dieulafoy lesion. During the closure with titanium clamps,  exposed arterial bleeding in the center of ulcer   occurred. Hemostatic forcep was immediately used to coagulate the bleeding vessel,  and no active bleeding was observed for 10 minutes. Then, the operator carried out purse string suture with titanium clip and nylon rope. The patient recovered well and followed up for three months without haematemesis or melena. Endoscopic therapies such as sclerotherapy, band ligation, electrocoagulation, overthescopeclip were widely used to patients with Dieulafoy lesion at present. The patient with purse string suture recovered well. Literature review showed  that purse string suture can provide a good successful rate with less postoperative complications for mucosal wound closure.

Key words: stomach ulcer, electrocoagulation, natural orifice endoscopic surgery