DIEULAFOY’S DISEASE IN FORENSIC PRACTICE

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Abstract


Dieulafoy’s disease is a genetically determined lesion manifested in a developmental malformation of the vessels in the submucosal layer of the stomach with arrosion of an abnormally large artery. Dieulafoy’s ulcer is relatively uncommon and causes 0.4–1 % of all acute gastric bleedings, twice as often in men than in women. With the advent of endoscopy, its mortality rate decreased from 80 to 20 %. At the macroscopic scale, Dieulafoy’s arrosion is oval or star-shaped, with the mucous membrane “raised” above the bleeding vessel in the form of a polyp. In 80 % of the cases, the haemorrhage occurs at a 5–6 cm distance from the oesophageal-gastric anastomosis, most commonly in the lesser curvature. Microscopically, the wall of the arrosed artery is affected by proliferation and sclerosis of the intima, degeneration of the middle layer and disappearance of elastic fibres. This article describes a case from forensic practice that may be of interest to doctors of various specialities. During autopsy of citizen F., his stomach was found to contain two litres of black-brown clotted blood. Examination of the gastric mucosa revealed a lesion in the lesser curvature 5 cm below the oesophageal aperture with characteristic histological markers of Dieulafoy’s disease. Accordingly, death of citizen F. was caused by a massive gastric haemorrhage of a mucosal lesion developed in progression of Dieulafoy’s disease. This case highlights the risks associated with this pathology, as a massive gastric bleeding without proper timely surgery is potentially lethal.

About the authors

V. V. Polyansky

Zabaikalsky Regional Bureau of Forensic Medical Expertise

Author for correspondence.
Email: bensman66@mail.ru
ORCID iD: 0000-0002-3911-4166

Russian Federation

Forensic Medical Expert,

Chita

O. A. Turanov

Zabaikalsky Regional Bureau of Forensic Medical Expertise;
Chita State Medical Academy

Email: 2runoff75rus@gmail.com
ORCID iD: 0000-0002-9688-7763

Russian Federation

Deputy Head;

Research Assistant, Department of Forensic Medicine, Jurisprudence and Bioethics,

Chita 

E. A. Sazonova

Zabaikalsky Regional Bureau of Forensic Medical Expertise

Email: evgenija_sazonova@rambler.ru
ORCID iD: 0000-0002-7172-0166

Russian Federation

Head of the Histological Department,

Chita

References

  1. Ульянов Д. Н., Канарейцева Т. Д., Ким Д. О. Артериовенозные мальформации желудка как причина рецидивирующих желудочно-кишечных кровотечений. Экспериментальная и клиническая гастроэнтерология. 2010;11:107–110.
  2. Кочуков В. П., Розанов А. Н., Островерхова Е. Г., Бунин И. В., Адеева Е. Ю., Нуждин И. Л. и др. Редкая причина желудочно-кишечного кровотечения (язва Дьелафуа). Трудный пациент. 2012;10(8–9):39–41.
  3. Шульга И. П., Лазарева И. Н. Случай смерти при клинически не установленном диагнозе в результате болезни Дьелафуа. Избранные вопросы судебно-медицинской экспертизы. 2010;11:101–104.
  4. Заговеньев И. Г., Заговеньева С. Н., Дубовко В. Р., Полфунтиков А. А., Турушева Л. С. Язва Дьелафуа в практике хирургов больницы скорой медицинской помощи. Эндоскопическая хирургия. 2013;19(1):36–38.

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Copyright (c) 2020 Polyansky V.V., Turanov O.A., Sazonova E.A.

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