Korean J Gastroenterol.  2013 May;61(5):279-281. 10.4166/kjg.2013.61.5.279.

A Case of Dieulafoy Lesion of the Jejunum Presented with Massive Hemorrhage

• Han MS
• Park BK
• Lee SH
• Yang HC
• Hong YK
• Choi YJ

• KMID: 1501650
• DOI: http://doi.org/10.4166/kjg.2013.61.5.279

Abstract

The Dieulafoy lesion is a rare cause of severe gastrointestinal hemorrhage. Although it may occur anywhere in the gastrointestinal tract, the lesion is most commonly located in the stomach, and the small bowel is an extremely uncommon site. Since Dieulafoy lesion in the small bowel is difficult to access by endoscopy, it seems impossible to diagnose and treat by initial endoscopy unlike the lesions in stomach. We experienced a case of Dieulafoy lesion of jejunum with massive hemorrhage in 54-year-old male. Active jejunal bleeding was shown by computed tomography scan and mesenteric angiography. Partial resection of the jejunum was performed. Final pathologic finding revealed Dieulafoy lesion of the jejunum.

Keyword

Dieulafoy lesion; Gastrointestinal Hemorrhage; Jejunum

MeSH Terms

Angiography
Gastrointestinal Hemorrhage/complications/*diagnosis
Humans
Jejunal Diseases/complications/*diagnosis/surgery
Male
Mesenteric Arteries/radiography
Middle Aged
Tomography, X-Ray Computed

Figure

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  Fig. 1. Axial section of CT scan showing bleeding focus in the jejunum (arrow) at arterial phase (A), and contrast leakage into jejunum (arrow) at venous phase (B). (C) CT angiography showing arterial bleeding on jejunum (arrow).

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  Fig. 2. Mesenteric angiography showed ectatic artery accompanied by contrast extravasation and staining (arrow) at the jejunum level.

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  Fig. 3. A microscopic finding of resected bowel specimen showed erosive mucosa in contact with a large tortuous submucosal vessel filled with thrombi (H&E, ×125).

Reference

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