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- W2977952208 abstract "Dieulafoy's lesions may be an unrecognized cause of small-bowel hemorrhage especially in young patients. We report a case of a jejuenal Dieulafoy's lesion that caused massive gastrointestinal hemorrhage ultimately discovered at lapartomy. Case Report: A 25 year old Hispanic woman presented with a third episode of hematochezia that started ten days earlier. She was hospitalized twice at different facilities requiring multiple blood transfusions. An extensive workup including upper and lower endoscopies, a tagged red blood cell scan, small bowel follow through and a Meckel's scan were all reported as normal. In our hospital, repeat endoscopies and a video capsule endoscopy were all unremarkable. The patient had an angiogram which revealed extravasation of contrast from a mid jejunal branch of the superior mesenteric artery. This did not respond to angiographic intervention. The patient was subsequently taken to surgery. An intraoperative enteroscopy revealed a 4mm Dieulafoy's lesion in the jejunum located 60 cm from the ligament of Treitz. The affected area was resected and pathology confirmed a Dieulafoy's lesion. The patient had an uneventful recovery and was discharged home. Discussion: Dieulafoy's lesion is an important cause of obscure gastrointestinal hemorrhage. The underlying cause is of an abnormal, submucosal artery that protrudes through a minute 2–5 mm mucosal defect. These lesions most commonly occur in the proximal stomach, within 6 cm of the gastroesophageal junction. The second most common site is the bulb of the duodenum. Dieulafoy's lesions of the jejunum, ileum and colon are rare accounting for only 1% (1). Mino et al (2) reviewed 41 cases of small intestinal Dieulafoy's lesions over a 30 year period and found that 2/3 of the patients were below the age of 40. Furthermore, the disease often occurred in patients in their teens and twenties. This emphasizes the importance of Dieulafoy's lesion as a cause of bleeding in young patients with G.I. bleeding of obscure origin. Poster presentation with pictures. Dieulafoy's lesions may be an unrecognized cause of small-bowel hemorrhage in young patients. A high index of suspicion is necessary when the source of bleeding can't be identified despite multiple interventions." @default.
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- W2977952208 date "2006-09-01" @default.
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- W2977952208 title "Massive Gastrointestinal Bleeding as a Result of a Dieulafoyʼs Lesion in the Jejunum" @default.
- W2977952208 doi "https://doi.org/10.14309/00000434-200609001-00873" @default.
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