"Doctor, I have been vomiting blood and having black stools recently." Mr. Li, who is over seventy years old, came to Putuo District People's Hospital for treatment because of repeated bleeding, coughing up blood, vomiting blood, and black stools.
"I went for a checkup before, but I couldn't find a clear bleeding point! I was hospitalized for a while, and the symptoms were relieved. Now I'm vomiting blood again, and I'm really worried." Mr. Li told reporters with some anxiety that in the past few years I had a similar coughing up of blood before. I thought it was a problem with my lungs, but I didn't expect to go to the hospital and find out that it was gastrointestinal bleeding.
Surgery scene
Old man Li went to Putuo District People's Hospital for emergency endoscopy. Wu Jianye, director of the Department of Gastroenterology, discovered during the examination that there was a large amount of fresh blood and blood clots in Mr. Li's stomach. "There is a lot of bleeding, but there are no obvious hemorrhagic lesions in the mucosa of the esophageal wall, stomach wall, and duodenal wall, which means that the problem still lies in the stomach." He conducted a "carpet-style" search of Old Man Li's stomach through a gastroscope. However, no hemorrhagic lesions were found.
"Found it, the bleeding point is here!" Just as Wu Jianye turned Uncle Li's position to lie on his right side, after the retention in the stomach moved, he found a bloody spot on the back wall of the stomach near the fundus. Clot, bright red blood began to gush out after careful and repeated flushing. "It's a Du type ulcer!" Through submucosal injection treatment and hemostatic clip treatment, Wu Jianye successfully stopped the bleeding.
The professional name of "Duchenne ulcer" is constant diameter artery syndrome. It is a rare disease with an incidence rate of approximately 0.3%-6.8%. Because the lesions are small and difficult to find, and the bleeding volume is large, it can easily lead to recurrence of the disease, and in severe cases, it can be life-threatening. Unlike the erosion of the blood vessels at the base of the ulcer, there is no ulcer formation around the diseased artery in Duchenne ulcer, or there is only slight mucosal erosion. "When blood pressure drops and thrombosis forms, bleeding can temporarily stop, and the originally exposed blood vessels 'sneak' under the mucosa. However, once the thrombus and blood clots fall off, massive bleeding can recur, making diagnosis and treatment difficult." Director Wu introduced .
In addition, the onset of Duchenne ulcer is sudden, usually without obvious upper abdominal pain and discomfort, and manifests as intermittent and repeated vomiting of blood and melena, a drop in blood pressure, and is often accompanied by hemorrhagic shock. Therefore, doctors remind that gastrointestinal bleeding is a more dangerous disease, especially acute and massive bleeding, which often causes symptoms such as vomiting blood, black stools, dizziness, and cold sweats. If the above symptoms occur, you should go to the hospital for examination and treatment in time.
The Department of Gastroenterology, Putuo District People's Hospital of Shanghai is a designated hospital in Putuo District for the Shanghai Colorectal Cancer Screening Project. It provides services on acute and chronic gastritis, gastroesophageal reflux disease, gastrointestinal bleeding, peptic ulcer, functional dyspepsia, and gastrointestinal disorders. , inflammatory bowel disease, chronic liver disease and its complications, acute pancreatitis, early digestive tract cancer and other diseases. We have accumulated rich experience in early digestive tract cancer screening and minimally invasive treatment, hemostasis of gastrointestinal bleeding, sclerotherapy of internal hemorrhoids, gastrointestinal stent placement, and treatment of esophageal and gastric varices in liver cirrhosis.
Source: Shanghai Putuo
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