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Paul Georges Dieulafoy

Paul Georges Dieulafoy

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Paul Georges Dieulafoy was a French
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

 physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 and surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...

. He is best known for his study of acute appendicitis and his description of Dieulafoy's lesion
Dieulafoy's lesion
Dieulafoy's lesion is a medical condition characterized by a large tortuous arteriole in the stomach wall that erodes and bleeds. It can cause gastric hemorrhage but is relatively uncommon. It is thought to cause less than 5% of all gastrointestinal bleeds in adults...

, a rare cause of gastric bleeding.

Life, studies, and career



Dieulafoy was born in Toulouse
Toulouse
Toulouse is a city in the Haute-Garonne department in southwestern FranceIt lies on the banks of the River Garonne, 590 km away from Paris and half-way between the Atlantic Ocean and the Mediterranean Sea...

. He studied medicine in Paris
Paris
Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...

 and earned his doctorate
Doctorate
A doctorate is an academic degree or professional degree that in most countries refers to a class of degrees which qualify the holder to teach in a specific field, A doctorate is an academic degree or professional degree that in most countries refers to a class of degrees which qualify the holder...

 in 1869.
Dieulafoy later became Chief of Medicine at the famed Hôtel-Dieu de Paris
Hôtel-Dieu de Paris
The Hôtel-Dieu de Paris is regarded as the oldest hospital in the city of Paris, France, and is the most central of the Assistance publique - hôpitaux de Paris hospitals. The hospital is linked to the Faculté de Médecine Paris-Descartes...

, taught pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

 in the University of Paris
University of Paris
The University of Paris was a university located in Paris, France and one of the earliest to be established in Europe. It was founded in the mid 12th century, and officially recognized as a university probably between 1160 and 1250...

, and was elected president of the French Academy of Medicine
Académie Nationale de Médecine
Académie Nationale de Médecine, or National Academy of Medicine was created in 1820 by king Louis XVIII at the urging of baron Antoine Portal. At its inception, the institution was known as the Académie Royale de Médecine...

 in 1910.
He died in Paris on August 16, 1911.

Contributions


He perfected a pump-like device for use in thoracentesis
Thoracentesis
Thoracentesis , also known as thoracocentesis or pleural tap, is an invasive procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes. A cannula, or hollow needle, is carefully introduced into the thorax, generally after administration of local anesthesia...

, and extensively studied pleurisy
Pleurisy
Pleurisy is an inflammation of the pleura, the lining of the pleural cavity surrounding the lungs. Among other things, infections are the most common cause of pleurisy....

 and liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

 conditions including hydatid disease and epidemic hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...

.
However, he is perhaps best known for his study of appendicitis
Appendicitis
Appendicitis is a condition characterized by inflammation of the appendix. It is classified as a medical emergency and many cases require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly because of the risk of rupture leading to...

. Dieulafoy described its early symptoms and clinical manifestations in detail, most notably the collection of symptoms now known as Dieulafoy's triad (more below), and was one of the first physicians to stress the importance of surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 in the treatment of this condition. He declared: "Le traitement médical de l'appendicite aiguë n'existe pas (The medical treatment of acute appendicitis does not exist)". His Handbook of Internal Pathology, published from 1880 to 1884, was widely used at the time. Between 1899 and 1910 he also published, in several volumes, the case reports from his private practice.

In 1890, Dieulafoy, André Chantemesse
André Chantemesse
André Chantemesse was a French bacteriologist born in Le Puy-en-Velay, Haute-Loire.From 1880 to 1885 he served as interne des hôpitaux in Paris, earning his doctorate in 1884 with a dissertation on adult tuberculous meningitis titled Étude sur la méningite tuberculeuse de l'adulte : les formes...

 and Georges-Fernand Widal
Georges-Fernand Widal
Georges-Fernand-Isidor Widal; was a French physician.From 1886 to 1888 he devoted himself to public demonstrations of the researches of the faculty of pathological anatomy, and during the 2 years following was in charge of a course in bacteriology in the laboratory of Professor Victor André Cornil...

 described a pulmonary condition found in persons who habitually fed pigeons in the streets. They termed it "mycotic pseudotuberculosis", now known as allergic bronchopulmonary aspergillosis
Allergic bronchopulmonary aspergillosis
In medicine, allergic bronchopulmonary aspergillosis is a condition characterised by an exaggerated response of the immune system to the fungus Aspergillus . It occurs most often in patients with asthma or cystic fibrosis...

.

Eponyms

  • Dieulafoy's lesion
    Dieulafoy's lesion
    Dieulafoy's lesion is a medical condition characterized by a large tortuous arteriole in the stomach wall that erodes and bleeds. It can cause gastric hemorrhage but is relatively uncommon. It is thought to cause less than 5% of all gastrointestinal bleeds in adults...

    : the protrusion of an arteriole
    Arteriole
    An arteriole is a small diameter blood vessel in the microcirculation that extends and branches out from an artery and leads to capillaries.Arterioles have muscular walls and are the primary site of vascular resistance...

     through the gastric mucosa, usually found just below the gastroesophageal junction; subsequent rupture of the arteriole is a rare cause of upper gastrointestinal bleeding
  • Dieulafoy's triad: hyperesthesia
    Hyperesthesia
    Hyperesthesia is a condition that involves an abnormal increase in sensitivity to stimuli of the sense. "When a non-noxious stimulus causes the sensation of pain the area will be termed hyperaesthetic". Stimuli of the senses can include sound that one hears, foods that one tastes, textures that...

     of the skin, exquisite tenderness and guarding over McBurney's point
    McBurney's point
    McBurney's point is the name given to the point over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the navel...

    , considered a classic sign
    Medical sign
    A medical sign is an objective indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....

     of acute appendicitis
  • Dieulafoy's apparatus: a pump-like device to evacuate fluid from the pleural cavity
    Pleural cavity
    In human anatomy, the pleural cavity is the potential space between the two pleura of the lungs. The pleura is a serous membrane which folds back onto itself to form a two-layered, membrane structure. The thin space between the two pleural layers is known as the pleural cavity; it normally...