Dieulafoy's Lesion In The Oesophagus: A Rare Cause Of Upper Gastrointestinal Bleeding

BMJ Case Rep. 2018 Feb 7:2018:bcr2017221552. doi: 10.1136/bcr-2017-221552.

Abstract

A Dieulafoy's lesion is defined as a dilated, aberrant, submucosal artery that erodes overlying mucosa in the absence of an underlying ulcer, aneurysm or intrinsic mural abnormality. It is a rare cause of upper gastrointestinal (GI) bleed with a very high mortality rate if it goes unidentified. It is most commonly located in the lesser curvature of the stomach but is extremely rare in the oesophagus. We are reporting a 55-year-old man who had massive haematemesis. Emergent endoscopy showed Dieulafoy's lesion in the distal oesophagus. It was sclerosed using endoscopic therapy. Patient's symptoms of GI bleeding resolved, and he was discharged home in a stable manner. Although a Dieulafoy's lesion is exceedingly rare in the oesophagus, it is associated with a high mortality if undiscovered. Its amenability to life-saving endoscopic therapy prompts us to keep this as a possible differential diagnosis of an upper GI bleed.

Keywords: endoscopy; gastroenterology; gi bleeding.

Publication types

  • Case Reports

MeSH terms

  • Arteriovenous Malformations / complications*
  • Arteriovenous Malformations / diagnosis
  • Arteriovenous Malformations / surgery
  • Blood Transfusion
  • Diagnosis, Differential
  • Esophagoscopy / methods
  • Esophagus / blood supply*
  • Gastrointestinal Hemorrhage / etiology*
  • Hematemesis / etiology
  • Humans
  • Male
  • Middle Aged