Dieulafoy's lesion in small intestine

Abstract

Dieulafoy's lesion is a rare cause of gastrointestinal (GI) bleeding. It accounts for 0.3%–1.5% of major GI bleed. It is typically found in the stomach. Small intestinal Dieulafoy's lesion is very rare. In the small intestine, Dieulafoy's lesion is most commonly seen in the jejunum. Hereby, we present one such case. A 36-year-old female attended the department of gastrosurgery with complaints of pain abdomen and generalized weakness for 15 days. She also had on and off melena and hematochezia. She was admitted with a diagnosis of obscure GI bleeding and was taken up for laparotomy. On table, enterotomy and retrograde enteroscopy was performed. There was a lesion over the distal jejunum. That segment of the intestine was resected. The specimen was sent for histopathological examination. The luminal surface of the intestine showed a small, whitish nodule measuring 0.3 cm in diameter. This nodule was noted beneath the mucosa, in the subepithelium. The overlying mucosa was ulcerated. Histopathological examination established the lesion to be of Dieulafoy's. Awareness, careful endoscopy, and histopathological examination are essential to diagnose Dieulafoy's lesion.