A Dieulafoy's lesion in a duodenal diverticulum. An infrequent cause of UGIB

Rev Esp Enferm Dig. 2018 Apr;110(4):266-267. doi: 10.17235/reed.2018.5396/2017.

Abstract

We present the case of an 82-year-old man with a history of heart failure, mitral regurgitation, type 2 DM, hypertension, dilated cardiomyopathy and a paroxysmal atrial flutter. The patient was under treatment with Sintrom. The patient presented to the emergency department due to melenic depositions of a one day evolution and dietary vomiting. There was no rectal bleeding and the patient was admitted three months previously due to self-limited melena with a normal gastroscopy. Anemia of 8 g and an overdose of Sintrom was diagnosed. A gastroscopy was performed and a large duodenal diverticulum with a fresh clot was found that was washed. A Dieulafoy lesion was subsequently found underneath with jet bleeding, which was sclerotic with adrenaline and a hemoclip. There was a favorable evolution after correcting the coagulopathy.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Diverticulum / complications*
  • Diverticulum / surgery
  • Duodenal Diseases / complications*
  • Duodenal Diseases / surgery
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Male