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Colonic Bleeding
Published in John F. Pohl, Christopher Jolley, Daniel Gelfond, Pediatric Gastroenterology, 2014
Louis Ghanem, Benjamin A Sahn, Petar Mamula
An arteriovenous malformation (AVM) is an anomaly of vascular morphology that shunts blood directly from the arterial to venous system. Congenital and acquired AVMs are described. Determining the incidence of intestinal AVM in children is difficult as many lesions remain asymptomatic or only become symptomatic in adulthood. A Dieulafoy lesion is a unique arteriole malformation characterized by a large tortuous submucosal arteriole that does not divide into a normal capillary bed, and may erode through a defect in the overlying mucosa. The lesion is classically found in the lesser curvature of the stomach (54.12), but has been described in the small intestine and colon.
Dieulafoy lesions as cause of upper gastrointestinal bleeding in a patient with portal hypertension
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Fahad Malik, Omar Al Salman, Marwah Alchalabi, Shobhana Chaudhari, Ali Tariq Khan
Dieulafoy’s lesion is an abnormal, large and tortuous submucosal artery that protrudes through a mucosal defect and results in bleeding, with an incidence rate of 0.3% to 6.7%. The etiology remains uncertain but has been linked to alcoholism and antiplatelet drugs [1,2]. Effective homeostatic modalities include: endoscopy with a combination of epinephrine injection followed by probe coagulation, hemoclip placement, angiographic embolization, or surgery [3]. Angiography is the next best step in management if endoscopic methods fail [4]. This case emphasizes the importance of considering uncommon causes of upper gastrointestinal bleeding in patients with portal hypertension and concomitant nonsteroidal anti-inflammatory drug use.
Meckel’s Diverticulum with Dieulafoy’s Lesion: A Cause of Severe Hematochezia
Published in Fetal and Pediatric Pathology, 2021
First described in 1898 by French surgeon George Dieulafoy, Dieulafoy’s lesion (DL) is a vascular abnormality characterized by a large tortuous submucosal arteriole that erodes the overlying mucosa and leads to massive bleeding if ruptured. DL can occur throughout the gastrointestinal tract. The most common site is the stomach, which accounts for nearly three-quarters of all DLs, followed by the duodenum, esophagus, colon, and small intestine [6,7]. Although DL is one of the significant causes of severe gastrointestinal bleeding, it has not been suggested as the cause of hematochezia in MD. In this study, we investigated the presence of DL in MD by histological examination and clarified the cause of massive bleeding in MD.
Dieulafoy lesions and gastrointestinal bleeding
Published in Baylor University Medical Center Proceedings, 2020
Carissa Teresa Rodriguez, Joseph Scott H. Bittle, Thomas James Kwarcinski, Selina Juarez, Jonathan Robert Hinshelwood
A Dieulafoy lesion is a dilated, submucosal artery that can result in spontaneous rupture and massive gastrointestinal bleeding. It is often identified incidentally as a prominent, linear, or serpiginous submucosal artery. Traditionally, these lesions were treated with endoscopic therapy. In recent years, transarterial/transcatheter embolization of Dieulafoy lesions by interventional radiologists has become more prominent due to its safety, effectiveness, and minimal complications.1 We present a case of a Dieulafoy lesion found incidentally on computed tomography angiography of the chest that was treated successfully with transarterial embolization.