An uncommon cause of life-threatening gastrointestinal bleeding: 2 synchronous Dieulafoy lesions

Marangoni, Gabriele; Cresswell, Adrian Ben; Faraj, Walid; Shaikh, Hizbullah; Bowles, Matthew

doi:10.1016/j.jpedsurg.2008.09.033

Cited by 58 publications

(76 citation statements)

References 10 publications

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“…3,8,10,19 There are cases in the literature of newborns being affected, 5 while rare, this could support the suggestion that these lesions are in fact congenital in nature. 2,5,8,12 Interestingly, it has been observed from case histories that a large proportion of patients presenting with rupture are already hospitalised. This has led to the suggestion of stress injury and predilection for the infirm.…”

Section: Aetiologymentioning

confidence: 55%

“…3,7,10,11 In just over 100 years since Dieulafoy's original paper there had been more than 280 reported cases world-wide. 4 The first case of two synchronous bleeding Dieulafoy's lesions, located on the greater curve of the stomach and in the jejunum, was recently reported by Marangoni et al 5 …”

Section: Dieulafoy's Lesionmentioning

confidence: 98%

“…It is difficult to determine its true incidence in the general population accurately as they are silent until presentation and, even then, it can pose a diagnostic challenge. They are believed to account for only 1-2% of acute GI bleeding, [3][4][5] but are arguably under-recognised rather than being truly rare. The lack of awareness about the Dieulafoy's lesion contributes to its 'rarity', increase in morbidity, and also the previously reported mortality of up to 80% associated with this lesion.…”

Section: 3mentioning

confidence: 99%

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Dieulafoy's lesion: current trends in diagnosis and management

Baxter

Aly

2010

annals

288

372

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Ann R Coll Surg Engl 2010; 92: 548-554 548The incidence of acute gastrointestinal bleeding ranges from 50-150 per 100,000 of the population each year. It is caused by peptic ulcers and oesophageal or gastroduodenal erosions in almost 80% of patients.1 Obscure gastrointestinal bleeding is reported to account for up to 5% of all gastrointestinal (GI) haemorrhages. It is defined as overt or occult bleeding from a source that cannot be readily determined by standard investigations, such as barium studies and endoscopic investigation. The source is often difficult to locate because the pathology is anatomically inaccessible, small, or subtle. Dieulafoy's lesion is one of the causes of obscure gastrointestinal bleeding that could result in treacherous and life-threatening gastrointestinal haemorrhage. 2,3A Dieulafoy's lesion, also termed 'calibre persistent artery', 2 is a relatively rare, but potentially life-threatening, cause of haemorrhage from the gastrointestinal tract. It is difficult to determine its true incidence in the general population accurately as they are silent until presentation and, even then, it can pose a diagnostic challenge. They are believed to account for only 1-2% of acute GI bleeding, [3][4][5] but are arguably under-recognised rather than being truly rare. The lack of awareness about the Dieulafoy's lesion contributes to its 'rarity', increase in morbidity, and also the previously reported mortality of up to 80% associated with this lesion.6 Rare or not, the precarious nature of the presentation make it necessary to include them in differential diagnosis of any acute GI haemorrhage. The aim of this article is to present an up-to-date review of literature on Dieulafoy's lesion and the recent trends in its diagnosis, treatment and prognosis. Materials and MethodsUsing Medline, a literature search was performed for papers published in English, using the text words 'Dieulafoy'(s)' and 'gastrointestinal bleeding'. All retrieved papers which were relevant to the study were analysed and the findings are summarised in this review. Overall, 159 Dieulafoy's lesion: current trends in diagnosis and management M Baxter, EH AlyLaparoscopic Colorectal Surgery and Training Unit, Aberdeen Royal Infirmary, Aberdeen, UK ABSTRACT BACKGROUND Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2% of acute gastrointestinal (GI) bleeding, but arguably is under-recognised rather than rare. Its serious nature makes it necessary to include it in the differential diagnosis of obscure GI bleeding. The aim of this study was to review the current trends in the diagnosis and management of Dieulafoy's lesion. MATERIALS AND METHODS Using Medline, a literature search was performed for articles published in English, using the search words 'Dieulafoy'(s)' and 'gastrointestinal bleeding'. All retrieved papers were analysed and the findings are summarised in this review. RESULTS There is no consensus on the treatment of Dieulafoy's lesions. Therapeutic endoscopy can control t...

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Section: Aetiologymentioning

confidence: 55%

Section: Dieulafoy's Lesionmentioning

confidence: 98%

Section: 3mentioning

confidence: 99%

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Dieulafoy's lesion: current trends in diagnosis and management

Baxter

Aly

2010

annals

288

372

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“…In a majority of the adult cases, endoscopic hemostasis with balloon-assisted enteroscopy can replace surgery (11)(12)(13), while pediatric patients are usually treated with embolization or surgery (16,17,19). In our case, surgery with intraoperative endoscopy was the last and best treatment option due to failure of identifying the bleeder with balloon-assisted enteroscopy and deteriorated hemodynamics.…”

Section: Discussionmentioning

confidence: 80%

“…To our knowledge, there were approximately 30 reported cases with jejunal DL based on the literature review, of which only four were about pediatric patients (14,16,17). Adult case series reported successful hemostasis with balloon-assisted enteroscopy in patients with DL of the small bowel (11,12).…”

Section: Discussionmentioning

confidence: 99%

Jejunal Dieulafoy Lesion Detected by Intraoperative Endoscopy in a Child

et al. 2016

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Introduction: Dieulafoy lesion is an unusual cause of gastrointestinal bleeding in which significant, and often recurrent, hemorrhage occurs from a pinpoint non-ulcerated arterial lesion. It is usually located in gastric fundus, and is extremely rare in children. Case Presentation: In this study, we present a male adolescent with jejunal Dieulafoy lesion. The patient was admitted to the hospital due to hematochezia and hypotension. No active bleeders were identified on endoscopy, colonoscopy, and double-balloon enteroscopy. Computed tomography angiography revealed active bleeders in jejunum. An intraoperative enteroscopy, using flexible endoscopy, revealed a jejunal Dieulafoy lesion with spurting bleeding. The patient was successfully treated by bowel resection. Conclusions: Intraoperative endoscopy is a relatively efficient and safe modality for evaluating the bleeding Dieulafoy lesion in the small intestine, and is essential for directing surgery.

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Drugs-Induced Injury, Infections, Vascular, Congenital, and Miscellaneous Disorders

Chandan

2019

Surgical Pathology of Non-Neoplastic Gastrointestinal Diseases

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An uncommon cause of life-threatening gastrointestinal bleeding: 2 synchronous Dieulafoy lesions

Cited by 58 publications

References 10 publications

Dieulafoy's lesion: current trends in diagnosis and management

Dieulafoy's lesion: current trends in diagnosis and management

Jejunal Dieulafoy Lesion Detected by Intraoperative Endoscopy in a Child

Drugs-Induced Injury, Infections, Vascular, Congenital, and Miscellaneous Disorders

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