Dieulafoy's lesion

Abstract

A review of 177 cases of upper gastrointestinal hemorrhage due to Dieulafoy's lesion is reported. Dieulafoy's lesion is frequently responsible for severe and recurrent upper gastrointestinal hemorrhage. The lesion was predominantly found in the proximal stomach. Repeat endoscopies were needed in 33% of the patients in order to make the correct diagnosis. When preoperative diagnosis and localization were made, surgery was an effective therapeutic modality. Therapeutic endoscopy was successful in achieving permanent hemostasis in 85% of the reported cases. Re-treatment was needed in an additional 10% and surgical therapy in 5% of the cases. Therapeutic endoscopy should be considered initially in all patients. Surgical intervention and angiography with embolization may be effective options if endoscopic therapy is unsuccessful.

Massive lower gastrointestinal bleeding from a jejunal Dieulafoy lesion

“…Schmulewitz et al (5) had described selective left gastric embolization in 3 patients with gastric DL. Recurrence rates after endoscopic or angiographic treatments vary within a range of 11%-22% (4,9). There are patients who undergo surgery because of recurrent bleeding after endoscopic treatment.…”

Massive Bleeding from Dieulafoy’s Lesion of the Small Intestine in a Child – Therapy for the Bleeding from Gastrointestinal Tract Out of Endoscopic Observation

“…The upper third of the stomach is the main location of Dieulafoy’s disease [1, 2]. Rarely the occurrence of the lesion has been identified in the duodenum, small intestine, colon and rectum.…”

“…Usually, this lesion is located in the proximal stomach within 6 cm of the gastroesophageal junction, although it may occur anywhere in the gastrointestinal tract [1, 2]. Less commonly, it has rarely been reported to occur in the antrum, duodenum, jejunum, colon and rectum.…”

A Case of Arteriovenous Malformation in the Submucosal Layer of the Stomach

“…Histologically, the eroded artery appears normal. There is no evidence of any mucosal inflammatory process, signs of deep ulcerations, penetration of the muscularis propria, vasculitis, aneurysm formation, or arteriosclerosis [6,27,28]. Our patient had a diffuse type of AV malformation involving whole of the stomach as the malformations were multiple therefore surgical procedure was not done.…”

“…In approximately 4-9% of massive upper gastrointestinal haemorrhage, no demonstrable cause can be found [10,11]. Dieulafoy's lesion is thought to be the cause of acute and chronic upper gastrointestinal bleeding in approximately 1-2% of these cases [12,13. It is thought to be more common in males (M: F = 2:1) [13,14] with a median age of 54 years at presentation [14,15]. Approximately 75% to 95% of Dieulafoy's lesions are found within 6 cm of the gastroesophageal junction, predominantly on the lesser curve [16].…”