Dieulafoy’s Lesion, A Rare But Potentially Fatal Cause of Gastrointestinal Bleeding Treated With Repeated Therapeutic Gastroscopies : A Case Report

Abstract

1.1. Introduction: Dieulafoy's lesion (DL) is an uncommon but important cause of recurrent upper gastrointestinal bleeding. Advances in endoscopy have increased the detection rate of Dieulafoy's lesions and have significantly decreased the mortality. Surgical resection was historically the first-line treatment of Dieulafoy's lesions, usually taking the form of gastrotomy and wide-wedge resectionor gastrectomy. This has now been overtaken by advances in endoscopic procedures. Surgical resection is currently reserved for the cases that are refractive to endoscopic or angiographic methods. Materials and Methods:we report a case of A 60-year-old male was admitted to our operative unit for a recurrent acute gastrointestinal bleeding hematemesis and melena. He had history of high blood pressure and abuse of NSAIDs. An upper endoscopy revealing a protrusion on the greater curvature just 5 cm below the cardia. The patient underwent four gastroscopies and only the last one was successful in ensuring hemostasis. Results:The post-operative period was uneventful and he was discharged seven days after the procedure. The follow-up visit 6 months later showed no complications due to the therapy and no extravasations, ulcerations or any other hemostatic disorders. Conclusion:Dieulafoy's can be successfully managed by endoscopic treatment. Endoscopic hemostasis with combined approaches can be repeated before resorting to surgical resection.