Jejunal Dieulafoy Lesion Detected by Intraoperative Endoscopy in a Child

Abstract

Introduction: Dieulafoy lesion is an unusual cause of gastrointestinal bleeding in which significant, and often recurrent, hemorrhage occurs from a pinpoint non-ulcerated arterial lesion. It is usually located in gastric fundus, and is extremely rare in children. Case Presentation: In this study, we present a male adolescent with jejunal Dieulafoy lesion. The patient was admitted to the hospital due to hematochezia and hypotension. No active bleeders were identified on endoscopy, colonoscopy, and double-balloon enteroscopy. Computed tomography angiography revealed active bleeders in jejunum. An intraoperative enteroscopy, using flexible endoscopy, revealed a jejunal Dieulafoy lesion with spurting bleeding. The patient was successfully treated by bowel resection. Conclusions: Intraoperative endoscopy is a relatively efficient and safe modality for evaluating the bleeding Dieulafoy lesion in the small intestine, and is essential for directing surgery.