合并十二指肠球部溃疡的胃杜氏病诊治分析

目的探讨合并十二指肠球部溃疡的杜氏病（Dieulafoy病）诊治要点。方法复习合并十二指肠球部溃疡的杜氏病19例临床资料。结果11例剖腹探查时遗漏了杜氏病病灶而仅行胃大部切除术，术后再出血。19例中经术前胃镜确诊8例。胃内发现血块4例。结论合并十二指肠球部溃疡的杜氏病容易遗漏，手术中发现十二指肠球部溃疡无明显活动性出血时，不能忽视其他微小病变的存在。术前胃镜和术中探查在杜氏病消化道出血的定位诊断中起重要作用。

Research of the diagnosis and treating of Gastric Dieulafoy complicating duodenobulbar ulcer

Objective To summarize the diagnosis and treating experience of Dieulafoy complicating duodenobulbar ulcer. Method 19cases of Gastric Dieulafoy complicating duodenobulbar ulcer diagnosed in our hospital in the past 10 years were retrospectively analyzed. Results 11 cases were omitted by mistake the lesion of Gastric Dieulafoy when undergoing exploratory laparotomy in other hospital and were perfumed subtotal gastrectomy only,followed rehaemorrhagia postoperatively. 8 cases were diagnosed by gastroscopy, and cruor were detected in the stomach in 4 cases. Conclusions Gastric Dieulafoy complicating duodenobulbar ulcer is omitted by mistake very easy. The genuine hemorrhagic focus should be confirmed when detecting duodenobulbar ulcer combined without active bleeding in the operation. Other minimal lesion should not be neglected. Preoperative gastroscopy and intraoperative exploration play an important role in localization diagnosis.