AI Summary & Key Takeaways
AI InsightDLs can occur synchronously, albeit very rarely, and a careful search for multiple lesions is necessary to avoid further bleeding.
📌 3 Key Takeaways
Abstract
Dieulafoy lesions (DLs) are dilated submucosal arterial structures visualized on endoscopy as bleeding foci on the superficial mucosa without erosion or ulceration. DLs account for 1–5.8% of acute non-variceal upper gastrointestinal bleeding cases.A 72-year-old male patient with known Alzheimer’s disease and coronary artery disease, being followed up at a nursing home, presented to our emergency department with foul-smelling, loose, and tarry stool. Esophagogastroduodenoscopy revealed a 3 mm DL immediately adjacent to the Z line in the distal esophagus, demonstrating a fresh blood clot without the appearance of a surrounding ulcer.Two endoscopic hemo- clips were applied to this lesion.The patient was monitored at the intensive care unit for the following 2 days and later transferred to internal medicine inpatient unit. He developed hematochezia on the 8th day of hospitalization. Emergent rectosigmoidoscopy was per- formed showing two separate 3 and 4 mm sized DLs, located immediately proximal to the dentate line.These lesions were successfully treated using two endoscopic band ligations. DLs can occur synchronously, albeit very rarely, and a careful search for multiple lesions is necessary to avoid further bleeding.