Chronic gastrointestinal bleeding caused by a Dieulafoy\u2019s lesion in the\xa0small intestine: a case report

Javad Salimi,Alireza Ramandi,Mehdi Jafarinia,Mohammad Pirouzian,Hamid Zand,Mohamad Behzadi

doi:10.1186/s13256-021-03121-9

Abstract

IntroductionDieulafoy’s lesion, first found by Paul Georges Dieulafoy, is an infrequent but important cause of recurrent upper gastrointestinal bleeding. The bleeding is usually severe, but patients rarely present with chronic, occult gastrointestinal bleeding.Case presentationIn this article, we discuss the case of a 68-year-old caucasian man with a history of recurrent hematemesis and chronic anemia with evidence of extravasation of contrast in the lumen of the bowel loop on computed tomography angiography. The patient was taken to the operating room, and a laparotomy procedure was performed.ConclusionDue to the infrequency of Dieulafoy’s lesion compared with other causes of gastrointestinal bleeding, it is often missed in the process of differential diagnosis. In this article, we have demonstrated the importance of this disease and different approaches to the treatment of this lesion, considering the location of the lesion among other factors.

Highlights

Dieulafoy’s lesion, first found by Paul Georges Dieulafoy, is an infrequent but important cause of recurrent upper gastrointestinal bleeding
Due to the infrequency of Dieulafoy’s lesion compared with other causes of gastrointestinal bleeding, it is often missed in the process of differential diagnosis
Dieulafoy’s lesions (DLs), first found by French surgeon Paul Georges Dieulafoy (1839–1911), were described as a superficial ulcer accompanied by a huge arteriole in the submucosal layer observed in the autopsied specimen

Summary

Conclusion

Dieulafoy’s lesions (DLs) could be life-threatening, acute, or chronic. Surgical treatment is advantageous with a low risk of re-bleeding, and surgery should be selected when patients are hemodynamically unstable and when other methods have failed. We recommend that DL should be considered as an important differential diagnosis in acute and chronic GI bleeding. Endoscopic modalities are chosen to treat DL, segmental resection and anastomosis are preferred in small bowel DL treatment

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