Dieulafoy's lesion is a rare but serious cause of
gastrointestinal bleeding, typically affecting older adults. It involves an
aberrant arteriole eroding the gastric mucosa, resulting in severe, recurrent
bleeding that poses diagnostic and management challenges. A review of the
literature revealed that, since the original description of Dieulafoy’s lesion
over 100 years ago, only 280 cases had been reported worldwide up to 2010. From
Bangladesh, only two cases have been reported, both described recently. This
study reported the case of a female in her mid-sixties who presented with
melena. She had coexisting left heart failure and chronic kidney disease.
Initial and repeat upper GI endoscopies were negative, but a subsequent
emergency endoscopy revealed bleeding from two sites near the gastroesophageal
junction. Hemostasis was achieved with argon plasma coagulation, and
Dieulafoy’s lesion was identified as the cause of her recurrent GI bleeding.
This case highlights the importance of considering Dieulafoy’s lesion (DL) in
the differential diagnosis of gastrointestinal haemorrhage, as it can cause
significant morbidity, weight loss, and may be missed during initial
investigations. Therefore, DL should be emphasised in postgraduate medical
curricula and always considered in patients presenting with GI bleeding.
Author(s) Details
Mamun Al Mahtab
Department of Hepatology, Bangladesh Medical University, Dhaka, Bangladesh.
Sheikh Mohammad Fazle
Akbar
Oita University, Oita / Miyakawa Memorial Research Foundation, Tokyo, Japan.
Musarrat Mahtab
Clinical Research Organization, Dhaka, Bangladesh.
Please see the book here :- https://doi.org/10.9734/bpi/msup/v7/7281
