A gastric Dieulafoy’s lesion

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Authors: Nehajová T.
Authors place of work: Interní oddělení a Gastroenterologické centrum, Nemocnice Třinec, p. o.
Published in the journal: Gastroent Hepatol 2019; 73(2): 149-153
Category: Gastrointestinální onkologie: kazuistika
doi: https://doi.org/10.14735/amgh2019149

Summary

A Dieulafoy’s lesion is a rare cause of bleeding from the gastrointestinal tract (GIT). It is a vascular lesion characterized by an abnormally tortuous and caliber-persistent artery in the submucosa, which can be a source of massive life-threatening bleeding. Dieulafoy’s lesions most commonly develop in the stomach; however, bleeding from such lesions has been reported throughout the GIT. Men are twice as likely to be diagnosed with a Dieulafoy’s lesion as women, especially if they suffer from polymorbidity. This most commonly presents as hematemesis and melena. Endoscopy is the method of choice for diagnosis and therapy. Thermal, mechanical, and injection techniques are the most effective means to stop the bleeding. The rate of recurrent bleeding is significantly lower with combination therapy than with monotherapy. If endoscopic methods fail, angiography (both diagnostic and therapeutic) can be performed. Surgical intervention is currently reserved for cases where therapeutic endoscopy and angiography have failed. Mortality of patients with Dieulafoy’s lesions has significantly decreased due to progress in endoscopy. This case report presents a young and healthy man with recurrent gastrointestinal bleeding caused by a gastric Dieulafoy’s lesion. Endoscopic treatment followed by vascular intervention led to closure of the aberrant vessel without recurrence of bleeding.

Conflict of Interest: Author declares that the article/manuscript complies with ethical standards, patient anonymity has been respected, and states that she has no financial, advisory or other commercial interests in relation to the subject matter.

Publication Ethics: The article/manuscript has not been published or is currently being submitted to another review.

The author agrees to publish her name and e-mail in the published article/manuscript.

Dedication: The article/manuscript is not supported by a grant nor has it been created with the support of any company.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted: 17. 1. 2019

Accepted: 12. 2. 2019

Keywords:

Dieulafoy’s lesion – gastrointestinal bleeding – therapeutic endoscopy

Zdroje

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