Dieulafoy's Lesion in the Gaster Secondary to the Resection of Lung Cancer: A Rare Case Report Presentation

Abstract Background: Dieulafoy’s lesion is a dilated, aberrant, submucosal vessel that erodes the overlying epithelium without obvious ulceration. Dieulafoy's lesion is a rare disease, meanwhile the lesion secondary to resection of lung cancer is even extremely rare. It is most commonly located in the lesser curvature of the stomach but rarely occurrences in extragastric sites have also been reported. To summarize the key points in the diagnosis and treatments of this disease, we present a clinical case of acute gastrointestinal bleeding due to Dieulafoy's lesion in the gaster secondary to resection of lung cancer.Case presentation: An 58-year-old woman presented with a clinical condition of haematemesis and haematochezia associated with anaemia and haemodynamic instability, needing blood transfusion. After many changes of body position, when the patient was in prone position, we finally found jet bleeding on the gastric body near the great curvature of gastric fundus under gastroscopy, and then we performed successfully with hemostatic clip placement. Hospitalization occurred without further com plications. There was no recurrence after 18 months follow-up.Conclusion: It is essential to be aware of this lesion as a possible cause of gastrointestinal bleeding and especially thoracic postoperative acute gastrointestinal appears. Timely and effective endoscopy can improve the diagnosis rate of these lesions and reduce the related mortality. At the same time, we need to pay attention to the patients with the risk factors in the perioperative period to reduce the incidence of Dieulafoy's lesion.

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An extremely rare case of a gastric accessory spleen: case report and review of the literature

BMC Gastroenterology ◽

10.1186/s12876-021-01852-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Guiqin Chen ◽

Lei Nie ◽

Tijiang Zhang

Keyword(s):

Rare Case ◽

Accessory Spleen ◽

Gastric Fundus ◽

Pathological Examination ◽

Review Of The Literature ◽

Gastric Bleeding ◽

Computed Tomographic ◽

Normal Spleen ◽

Elevated Lesion ◽

Lesser Curvature

Abstract Background The accessory spleen has no anatomical or vascular relationship with the normal spleen, The tissue structure and physiological function of the accessory spleen are the same as those of the normal spleen, which usually locate in the splenic hilum and the tail of the pancreas. The aims of this manuscript are to present a rare case of the gastric accessory spleen and a review of the literature. Case presentation A 19-year-old male patient was sent to the emergency department with stomach bleeding after drinking alcohol. The computed tomographic scan showed a 1.2 cm × 1.7 cm mass at the lesser curvature of the gastric fundus. Gastrointestinal endoscopy displayed a submucosal elevated lesion on the gastric fundus, and gastrectomy was performed. Postoperative pathological examination proved an accessory spleen in the stomach. The postoperative course was uneventful, and the patient was discharged on the 6th day after the surgery. Conclusions The accessory spleen at the fundus of stomach is extremely rare, especially in this case, which is accompanied by acute gastric bleeding, and it is difficult to diagnosis before operation. Many literatures reported that it was misdiagnosis as tumor, so it is necessary to diagnose accessory spleen correctly.

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Application of Fast Track Surgery Nursing in Perioperative Period of Lung Cancer

10.47939/mh.v2i3.81 ◽

2021 ◽

Keyword(s):

Lung Cancer ◽

Fast Track ◽

Perioperative Period ◽

Fast Track Surgery

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Gastrointestinal bleeding from Dieulafoy’s lesion: Clinical presentation, endoscopic findings, and endoscopic therapy

World Journal of Gastrointestinal Endoscopy ◽

10.4253/wjge.v7.i4.295 ◽

2015 ◽

Vol 7 (4) ◽

pp. 295 ◽

Cited By ~ 29

Author(s):

Borko Nojkov ◽

Mitchell S Cappell

Keyword(s):

Gastrointestinal Bleeding ◽

Clinical Presentation ◽

Endoscopic Therapy ◽

Dieulafoy’S Lesion ◽

Endoscopic Findings

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TOMOGRAPHIC FINDINGS OF GASTRIC GASTROINTESTINAL STROMAL TUMOR AND CORRELATION WITH THE MITOTIC INDEX

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032013000400002 ◽

2013 ◽

Vol 50 (4) ◽

pp. 244-250 ◽

Cited By ~ 2

Author(s):

Gustavo Lemos PELANDRÉ ◽

Maria Célia DJAHJAH ◽

Emerson Leandro GASPARETTO ◽

Marcelo Souto NACIF ◽

Edson MARCHIORI ◽

...

Keyword(s):

Gastrointestinal Stromal Tumor ◽

Mitotic Index ◽

Statistical Correlation ◽

Gastric Fundus ◽

The Body ◽

Stromal Tumor ◽

Gastric Body ◽

Dense Area ◽

Stromal Tumors ◽

Mesenteric Fat

ContextGastrointestinal stromal tumors are uncommon abdominal neoplasms and can affect any portion of the gastrointestinal tract.ObjectivesDescribe the tomographic findings of the gastrointestinal stromal tumor of gastric origin, correlating it with the mitotic index.MethodsTwenty-one patients were selected within the period of January 2000 and 2008, with histopathological and immunohistochemical diagnosis of gastric gastrointestinal stromal tumors, who presented computed tomography done before the treatment. The tomographic variables analyzed were lesion topography, dimensions, contours, morphology, pattern and intensity enhancement through venous contrast, growth pattern, invasion of adjacent organs, presence of ulceration, fistula, calcifications, infiltration of mesenteric fat, lymphadenopathy and metastasis. The mitotic index was determined through optic microscopy, counting the number of mitosis figures in 50 high power fields.ResultsThe tumors were located in the body (66.7%) or gastric fundus (33.3%), with dimensions varying between 4.2 and 21.2 cm (average of 10.5 cm). The growth was predominantly extraluminal (47.6%) or intra/extra luminal (28.6%). The enhancement by venous contrast was heterogeneous in 66.7%. The statistical analysis showed that irregular morphology (P = 0.027) and infiltration of mesenteric fat (P = 0.012) presented correlation with the high mitotic index.ConclusionsIn the present study, most part of the tumors were located in the gastric body, with average size of 10.5 cm, presenting central hypo dense area, heterogeneous enhancement through contrast and predominantly extra luminal growth. Irregular morphology and infiltration of mesenteric fat present statistical correlation with high mitotic level.

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Effect of respiratory training apparatus and vibration expectoration vest on expectoration in patients with lung cancer resection

Frontiers of Nursing ◽

10.1515/fon-2018-0042 ◽

2018 ◽

Vol 5 (4) ◽

pp. 285-289

Author(s):

Xiao-Jing Guo ◽

Li-Li Wei ◽

Xin-Hui Li ◽

Ning- Ning Yu ◽

Shao-Bo Gao ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Respiratory Function ◽

Perioperative Period ◽

Control Group ◽

Observation Group ◽

Pulmonary Atelectasis ◽

Cancer Resection ◽

Lung Cancer Patients ◽

Respiratory Training

Abstract Objective The aim of this study was to explore the safe and effective method of expectoration in the preoperative period of patients with lung cancer resection and to promote the rehabilitation of patients. Methods A total of 100 cases of lung cancer patients undergoing elective surgery were divided into the observation group and the control group, with 50 cases in each group. The control group was treated with vibration expectoration vest for expectoration during the perioperative period, and the observation group was treated with respiratory function exerciser that has expectoration function in the perioperative period, three times a day, and the effect was evaluated after 5 days. Results The number of patients in the observation group after the first expectoration time was significantly less than that of the control group (P<0.001). Pain score, pulmonary atelectasis, and pulmonary infection rate of the observation group were significantly lower than those of the control group; the hospitalization time was significantly shorter than that of the control group; and the difference was statistically significant (P<0.05). Conclusions Lobectomy for lung cancer patients with perioperative respiratory training for respiratory function exercise, compared with conventional methods, is helpful for postoperative expectoration and to reduce the incidence of adverse events.

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Cecum Dieulafoy’s Lesion Presenting with Recurrent Lower Gastrointestinal Bleeding: Case Report

Journal of Pharmacy and Pharmacology ◽

10.17265/2328-2150/2018.03.007 ◽

2018 ◽

Vol 6 (3) ◽

Author(s):

Ludmila Resende Guedes ◽

Silas Castro de Carvalho ◽

Vitor Nunes Arantes ◽

Arthur Manoel Braga de Albuquerque Gomes ◽

Daniel Antônio de Albuquerque Terra ◽

...

Keyword(s):

Case Report ◽

Gastrointestinal Bleeding ◽

Lower Gastrointestinal Bleeding ◽

Dieulafoy’S Lesion

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EUS-guided sampling with 25G biopsy needle as a rescue strategy for diagnosis of small subepithelial lesions of the upper gastrointestinal tract

Endoscopy International Open ◽

10.1055/a-0603-3578 ◽

2018 ◽

Vol 06 (07) ◽

pp. E892-E897 ◽

Cited By ~ 3

Author(s):

Filippo Antonini ◽

Sara Giorgini ◽

Lorenzo Fuccio ◽

Lucia Angelelli ◽

Giampiero Macarri

Keyword(s):

Diagnostic Yield ◽

Final Diagnosis ◽

Fine Needle Biopsy ◽

Gastric Fundus ◽

Gastric Body ◽

Biopsy Needle ◽

Duodenal Lesions ◽

Procedural Complications ◽

Subepithelial Lesions ◽

The Impact

Abstract Background and study aims This study was designed to evaluate the impact of additional tissue obtained with endoscopic ultrasound (EUS)-guided 25-gauge core biopsy needle (25G-PC) following an unsuccessful fine-needle biopsy (FNB) performed with larger-bore needles for the characterization of gastrointestinal subepithelial lesions (GI-SELs). Patients and methods We prospectively collected and retrospectively analyzed information in our database from January 2013 to June 2017 for all patients with GI-SELs who received a EUS-guided FNB (EUS-FNB) with 25G-PC during the same procedure after failure of biopsy performed with larger-bore needle. Diagnostic yield, diagnostic accuracy and procedural complications were evaluated. Results Sixteen patients were included in this study, 10 men and 6 women, median age 67.8 (range 43 to 76 years). Five patients were found to have a SEL localized in the distal duodenum, five in the gastric antrum, two in the gastric fundus and four in the gastric body. The mean size of the lesions was 20.5 mm (range 18 – 24 mm). EUS-FNB with 25G-PC enabled final diagnosis in nine patients (56.2 %). Regarding the subgroup of duodenal lesions, the procedure was successful in four of five (80 %). Final diagnoses with EUS-guided sampling were GIST (n = 6), leiomyoma (n = 2) and metastatic ovarian carcinoma (n = 1). No procedure-related complications were recorded. Conclusion In patients with small GI-SELs, additional tissue obtained with 25G-PC could represents a “rescue” strategy after an unsuccessful procedure with larger-bore needles, especially when lesions are localized in the distal duodenum.

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