Dieulafoy’s lesion, a dilated aberrant sub mucosal vessel which erodes the overlying epithelium in the absence of a primary ulcer, is a relatively rare but potentially fatal cause of gastrointestinal bleeding. Most commonly, the lesion is located the lesser curvature of the stomach. Iit is found less frequently in the duodenum and colon, respectively. Dieulafoy’s lesion of the esophagus is rarer still, and repeated endoscopy may be required in order to discover the lesion.
Dieulafoy’s lesion, though rare, should be a diagnostic consideration in young patients with unexplained massive GI bleeding.
It is diagnosed and treated endoscopically, however endoscopic ultrasound or angiography can be of benefit.
Endoscopic techniques used in the treatment include epinephrine
injection followed by bipolar electrocoagulation, monopolar
electrocoagulation, injection sclerotherapy, heater probe, laser
photocoagulation, hemoclipping or banding.