Dieulafoy’s lesion

A medical condition characterized by a large tortuous arteriole in the stomach wall that erodes and bleeds.

It can cause gastric hemorrhage, but causes less than 5% of all gastrointestinal bleeds in adults.

Thought to be a developmental malformation rather than degenerative changes.

Characterized by a single large tortuous arteriole in the submucosa which does not undergo normal branching and bleeds into the gastrointestinal tract through a defect in the mucosa.

Approximately 75% of such lesions occur in the upper part of the stomach within 6 cm of the gastroesophageal junction, most commonly in the lesser curvature.

Extragastric lesions have been identified with the duodenum the most common location (14%) followed by the colon (5%), surgical anastamoses (5%), the jejunum (1%) and the esophagus (1%).

Occurs twice as often in men as women.

Associated with hypertension, cardiovascular disease, chronic kidney disease, and diabetes.

Patients present with hematemesis and/or melena.

Difficult to diagnose, as bleeding is intermittent.

Endoscopy is diagnostic but it may be difficult to recognize the lesion, and angiography may be diagnostic during bleeding

Endoscopic techniques used in the treatment include epinephrine injection, electrocoagulation,, injection sclerotherapy, laser photocoagulation, hemoclipping or banding.


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