Endoscopic Management with Ethanol Injection in a Child with Gastric Dieulafoy Lesion

Dieulafoy 병변 소아의 내시경적 치료 1례

The Dieulafoy's lesion is a rare cause of recurrent massive gastrointestinal bleeding in children. The bleeding results from an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is commonly found on proximal stomach. Surgical intervention was believed to be the best treatment in the past, but recent advancement in endoscopy has made effective hemostasis possible. We report a case of a 9-year-old boy with underlying mycoplasma pneumonia with effusion who presented with massive upper gastrointestinal bleeding. Bleeding was controlled with endoscopic treatment by epinephrine and ethanol injection and the patient was successfully treated.

Dieulafoy 병변은 비정상적으로 확장된 점막하 동맥이 소화관 내로 노출되어 발생하는 병변으로 위장관 출혈의 드문 원인이다. 저자들은 폐렴으로 입원 중 다량의 토혈과 혈변을 보인 9세 남아에서 상부 소화관 내시경으로 Dieulafoy 병변을 진단하고 순수 에탄올 국소 주사법으로 성공적으로 치료하였기에 문헌 고찰과 함께 보고하는 바이다.