The Baader-Meinhof Phenomenon of Dieulafoy’s Lesion

Kolli, Sindhura; Dang-Ho, Khoi Paul; Mori, Amit; Gurram, Krishna C.

doi:10.7759/cureus.4595

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…While endoscopy has significantly improved survival for DLs, diagnosis remains a challenge with one study reporting only 49% of DLs were identified on initial endoscopy [ 2–4 , 7 ]. Factors which contribute to this include the intermittent nature of bleeding, small lesion size with an absence of abnormal surrounding mucosa, and a lack of clinical experience with the condition [ 1 , 4 , 7 , 8 ]. Additionally, it may further be obscured by pooling of blood or gastric contents [ 4 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Factors which contribute to this include the intermittent nature of bleeding, small lesion size with an absence of abnormal surrounding mucosa, and a lack of clinical experience with the condition [ 1 , 4 , 7 , 8 ]. Additionally, it may further be obscured by pooling of blood or gastric contents [ 4 , 7 ]. Duodenal angulations, folds and diverticulum may also further conceal DLs in the duodenum [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite advances in endoscopic techniques, the diagnosis of DLs remains difficult [ 1 , 3 ]. This is likely due to the varying presentations and intermittent bleeding of DLs, in combination with the infrequency of the condition and a lack of clinician familiarity [ 1 , 4 ]. This case explores the challenges of diagnosing a duodenal DL in the context of a concurrent gastric ulcer.…”

Section: Introductionmentioning

confidence: 99%

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A diagnostic dilemma: a case report of concomitant duodenal Dieulafoy lesion and gastric ulcer

Wallace,

Gallagher

2024

Journal of Surgical Case Reports

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Dieulafoy lesions (DL) are an uncommon cause of gastrointestinal bleeding which is often difficult to diagnose due to the rarity of the condition and varying clinical presentations. This case describes an unusual presentation of upper gastrointestinal bleeding in an 85-year-old female with findings on two separate gastroscopies of both a gastric ulcer and duodenal DL. The pathophysiology of DL remains poorly understood and despite shared risk factors, these two pathologies are rarely reported concurrently. The presence of a concomitant gastric ulcer further complicated the diagnosis and treatment of the duodenal DL in this case. This highlights the importance of clinician awareness of this pathology and its presentation and the need for early repeat endoscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A diagnostic dilemma: a case report of concomitant duodenal Dieulafoy lesion and gastric ulcer

Wallace,

Gallagher

2024

Journal of Surgical Case Reports

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“…It is an abnormal submucosal artery, which runs a tortuous course (1). Dieulafoy's lesions have been reported to be responsible for 1-5.8% of acute gastrointestinal bleeding (2,3), but they typically present with severe, urgent, and massive bleeding, which usually causes hemodynamic instability, and even death. Sometimes, they are difficult to detect by endoscopy or Pulsatile bleeding of the duodenal papilla after the clots were removed.…”

Section: Discussionmentioning

confidence: 99%

Case report: Endoscopic Hemoclip treatment for massive hematemesis caused by a Dieulafoy’s lesion on duodenal papilla caused acute pancreatitis

Xu²,

Shi³

et al. 2023

Front. Med.

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BackgroundDieulafoy’s lesion is an uncommon cause of hemorrhage of the digestive tract. It often presents with urgent and massive bleeding usually leading to shock, even death. Dieulafoy’s lesions have been reported throughout the digestive tract but which occurred on duodenal papilla were particularly rare and presented challenges in the choice of hemostasis.Case presentationA 66-year-old man with melena for 2 days was admitted. Gastrointestinal endoscopy revealed blood clots covering the duodenal papilla with oozing blood. During the procedure of trying to place a plastic stent into the duodenal papilla first, the hemorrhage began to present pulsating bleeding. The patient went into shock. With consent, two titanium clips were inserted to clamp the bleeding site to stop the bleeding. The patient complained of epigastric pain 14 h after the endoscopy. An abdominal CT scan showed signs of acute pancreatitis. Endoscopy was performed to remove the titanium clips and showed a vessel stump on the duodenal papilla. The patient was discharged from the hospital on the 14th day and followed for 6 months with no recurrence.ConclusionThis case was diagnosed with a Dieulafoy’s lesion on the duodenal papilla, which has rarely been reported. Hematemesis was stopped by clamping the vessel stump with titanium clips but caused acute pancreatitis. Reviewing the treatment, electrocoagulation might be a better choice, and life support treatment, including central vena catheterization and an adequate supply of blood products, should be prepared in advance to provide extra time for the stent placement or vascular intervention treatment.

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“…Dieulafoy lesion (DL) is a calibre persistent submucosal artery associated with a miniature mucosal defect, which was first described by Paul Georges Dieulafoy in 1897. 1 Most of DL is located in the stomach, within 6 cm of the gastro-esophageal junction, and rarely occur further along the gastrointestinal tract including duodenum, jejunum, ileum, cecum, appendix, colon and anal canal. 2 DL in children is rarely reported which is difficult to timely diagnose and can be fatal without appropriate treatment.…”

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confidence: 99%

Duodenal Dieulafoy lesion: a rare pathogeny of gastrointestinal bleeding in children

Liu¹,

Zhang²,

Li³

2022

Turk J Pediatr

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Background. Dieulafoy lesion is a calibre persistent submucosal artery associated with a minuter mucosal defect. Dieulafoy lesion has been reported to account for 1-5.8% of acute nonvariceal upper gastrointestinal bleeding in adults, but it is rarely reported in children. Case. Here we report a case of duodenal Dieulafoy lesion in a 13-year-old boy. After endoscopy and laparotomy, he still had no definite diagnosis and effective treatment. The duodenal Dieulafoy lesion was finally identified by selective angiography and was effectively treated by intravascular embolization. Conclusions. For unexplained upper gastrointestinal bleeding, the possibility of duodenal Dieulafoy lesion should be considered. A combination of multiple diagnosis and treatment methods can improve the success rate of diagnosis and treatment when a single test or treatment method cannot provide definitive diagnosis or effective treatment.

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The Baader-Meinhof Phenomenon of Dieulafoy’s Lesion

Cited by 6 publications

References 8 publications

A diagnostic dilemma: a case report of concomitant duodenal Dieulafoy lesion and gastric ulcer

A diagnostic dilemma: a case report of concomitant duodenal Dieulafoy lesion and gastric ulcer

Case report: Endoscopic Hemoclip treatment for massive hematemesis caused by a Dieulafoy’s lesion on duodenal papilla caused acute pancreatitis

Duodenal Dieulafoy lesion: a rare pathogeny of gastrointestinal bleeding in children

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