12th Ljudevit Jurak International Symposium on
Comparative Pathology
June 1-2, 2001

M. Tolovska, S. Kostadinova
Institute of Pathology, Faculty of Medicine, Skopje, Macedonia
Dieulafoy‘s disease is a vascular malformation of the gastric wall with abnormally dilated and tortuous arteries which are present in the submucous layer of the gastric wall and may penetrate the mucose. The disease is most frequently manifested as  gastrointestinal bleeding, the reason for which usually remains unknown after endoscopy.
Materials and methods: At the Institute of Pathology, Faculty of Medicine in Skopje, the third case of Dieulafoy‘s disease has been diagnosed in a 50-year-old patient. The previous two cases were verified in operative materials, and one of them was also confirmed during an autopsy. For this case, 2/3 resection of the gaster was obtained with clinical diagnosis of haemorrhagic ulcer, but an ulcerative lesion was not found the macroscopic examination. The mucose showed a small zone of haemorrhage with a suture. Tissue sections taken for the histological examination were routinely embedded in paraffin, stained with HeEo, and also with the histochemical staining methods for Van Gieson and orcein elastica.
Results: The definite diagnosis of the disease was made upon the histological analysis of the taken tissue sections. The mucose was completely intact, with haemorrhage in the lamina propria. The basic process was found in the submucose layer where abnormally dilated and tortuous arteries with thick walls and hypertrophied musculature were seen  a finding which corresponds to the Dieulafoy‘s disease. The superficial segments of the arteries were thrombosed, which indicated recent haemorrhaging. The above described changes were followed with a phlegmonous type of acute gastritis, which spread through the layers of the gastric wall and reaching the serose.
Conclusion: Since Dieulafoy‘s vascular malformation is almost always manifested with gastrointestinal bleeding and requires urgent surgical treatment; it is essential to have this unusual and rare disease in mind.
Poster Presentation