Role of imaging and endovascular radiology in endoscopically missed Dieulafoy’s lesion of stomach – A case report with review

Abstract

Dieulafoy’s lesion is an uncommon cause of life-threatening gastrointestinal bleed from a dilated and tortuous submucosal artery. With the advent of endoscopy-guided intervention, the mortality of the condition has reduced significantly from 80 to 8%. Imaging plays a vital role in diagnosing them in endoscopically negative cases. Endovascular management can also be offered for unidentified lesions or failed endoscopic treatment. We report a middle-aged male with acute hematemesis where endoscopy was unable to reveal the source of the bleed. Contrast CT detected the lesion, which was embolised by endovascular route. The clinical details, imaging appearance and treatment of this uncommon lesion is presented.

Dieulafoy's lesion, the endovascular approach as a therapeutic option when endoscopic treatment has failed: A case report and brief review

“…CT angiography is an excellent diagnostic tool for visualizing tortuous vessels, revealing the abnormal vessel caliber characteristic of Dieulafoy's lesion even during the arterial phase, without requiring contrast medium extravasation [5]. The treatment of this pathology through endoscopy involves the clipping of the abnormal vessel.…”