Independent case reportAn uncommon cause of life-threatening gastrointestinal bleeding: 2 synchronous Dieulafoy lesions
Section snippets
Case report
A 15-year-old previously healthy Afro-Caribbean female presented with melena and hematemesis.
At the time of admission, she was noted to be tachycardic and hypotensive with a hemoglobin level of 7.8 g/dL and a normal clotting profile. Her initial hemodynamics improved after moderate volume crystalloid resuscitation, but the melena did not settle, and the patient became hemodynamically unstable. An urgent upper gastrointestinal endoscopy revealed moderate amount of altered blood in the stomach
Discussion
Dieulafoy lesions can be the source of significant gastrointestinal bleeding and account for between 0.3% and 1.5% of major gastrointestinal bleeds [3]. Dieulafoy lesions are thought to be congenital and although reports suggest preponderance in men of advancing age, they have also been reported in infants [4]. The presence of 2 actively bleeding lesions has been previously described only once, with dual gastric lesions [5], which were treated by endoscopic clipping.
This is the first report of
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2021, International Journal of Surgery Case ReportsCitation Excerpt :The second hypothesis is based on a degenerative background caused by oxidative and ischemic stress of diverse or even multifactorial causes, such as chronic gastritis, previous surgeries, and alcohol consumption or non-steroidal anti-inflammatory drug usage [2,4,10–12]. Despite its uncertain pathogenesis, it is known that these vascular lesions are more frequent in the elderly or individuals with more underlying diseases [2,4,9,11,13]. Dieulafoy's lesions affect males twice as often as females and can occur at any age [2,5,14].
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2015, Clinical RadiologyCitation Excerpt :They are most commonly located along the lesser curvature, within 6–10 cm of the gastro-oesophageal junction.11 Although Dieulafoy lesions are commonly thought to be quite rare, accounting for only 1–2% of acute gastrointestinal bleeding,1,12 their apparent rarity is at least in part related to under-diagnosis. A Dieulafoy lesion is usually asymptomatic until presentation with an often massive bleed.
Multiple Gastric Dieulafoy Lesions
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