胃Dieulafoy病又称胃粘膜下恒径动脉破裂出血,临床较少报道,容易延误诊治。作者自1993～1995年间共收治4例,均误诊,现就误诊原因加以分析。 1 病例介绍例1.男性,19岁。自1991年以来先后4次大量呕血、解柏油样大便。首次出血于1991年5月6日,本院胃镜检查提示十二指肠球部溃疡。剖腹探查发现十二指肠球部前壁5mm×5mm溃疡,未见活动性出血,行胃大部分切除术。术后第5天再次呕血、解柏油样便,第2次剖腹探查见吻合口无活动性出血,残胃粘膜呈广泛小点状渗血,缝扎较大点状惨血。术后恢复好,17天后出院。1992年7月21日第3次大出血,胃镜示出血性残胃炎。经保守治疗出血停止,2周后出院。第4次出血于1993年5月7日,胃镜示残胃后壁4mm Gastric Dieulafoy disease, also known as gastric mucosal constant diameter arterial rupture bleeding, less clinical coverage, easy to delay diagnosis and treatment. From 1993 to 1995, the author received a total of 4 cases, were misdiagnosed, the reason is misdiagnosed to be analyzed. 1 Case Introduction Example 1. Male, 19 years old. Since 1991 a large number of hematemesis, relieve tarry stool. The first bleeding in May 6, 1991, our hospital gastroscopy prompted duodenal ulcer. Laparotomy found that the anterior wall of duodenal 5mm × 5mm ulcer, no active bleeding, the line of gastric resection. On the 5th postoperative day, hematemesis was again vomited and the asparagus was relieved. The second laparotomy showed no active hemorrhage in the anastomotic stoma. Postoperative recovery, 17 days after discharge. July 21, 1992 the third major bleeding, gastroscopy showed hemorrhagic gastritis. After conservative treatment of bleeding stopped, discharged after 2 weeks. The fourth bleeding on May 7, 1993, gastric endoscopic gastric remnant wall 4mm