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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2019; 73(2): 149–153. doi:10.14735/amgh2019149.

A gastric Dieulafoy’s lesion

Tatiana Nehajová

Summary

A Dieulafoy’s lesion is a rare cause of bleeding from the gastrointestinal tract (GIT). It is a vascular lesion characterized by an abnormally tortuous and caliber-persistent artery in the submucosa, which can be a source of massive life-threatening bleeding. Dieulafoy’s lesions most commonly develop in the stomach; however, bleeding from such lesions has been reported throughout the GIT. Men are twice as likely to be diagnosed with a Dieulafoy’s lesion as women, especially if they suffer from polymorbidity. This most commonly presents as hematemesis and melena. Endoscopy is the method of choice for diagnosis and therapy. Thermal, mechanical, and injection techniques are the most effective means to stop the bleeding. The rate of recurrent bleeding is significantly lower with combination therapy than with monotherapy. If endoscopic methods fail, angiography (both diagnostic and therapeutic) can be performed. Surgical intervention is currently reserved for cases where therapeutic endoscopy and angiography have failed. Mortality of patients with Dieulafoy’s lesions has significantly decreased due to progress in endoscopy. This case report presents a young and healthy man with recurrent gastrointestinal bleeding caused by a gastric Dieulafoy’s lesion. Endoscopic treatment followed by vascular intervention led to closure of the aberrant vessel without recurrence  of bleeding.

Keywords

Dieulafoy’s lesion, gastrointestinal bleeding, therapeutic endoscopy

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