An unusual cause of massive upper gastrointestinal bleeding: Dieulafoy's lesion within a giant midesophageal diverticulum

A Rare Case of Bleeding Epiphrenic Esophageal Diverticulum From Arteriovenous Malformations

Epiphrenic esophageal diverticula (EED) is a rare condition that usually presents with dysphagia in patients with a known motility disorder. In this article, we present a unique case of EED presenting with hemoptysis with clinical workup negative for any pulmonary pathology. Esophagogastroduodenoscopy revealed arteriovenous malformations within the EED successfully managed with argon plasma coagulation (APC), leading to a resolution of the patient’s symptoms.

Giant midoesophageal diverticulum--case report and review of the literature

INTRODUCTION

Midoesophageal diverticula >4cm in size are a medical rarity with a dozen reported cases so far. Usually, midoesophageal diverticula tend to be of small size and asymptomatic.

CASE REPORT

We herein present a case of a woman suffering from a midoesophageal diverticulum in a very large dimension--never described in the current literature before--who successfully underwent surgical resection via thoracotomy.

DISCUSSION

If symptomatic, common symptoms are dysphagia and regurgitation. The risk of malignant transformation is low. Treatment of midoesophageal diverticula is based on size and symptoms of the patient. Asymptomatic or small diverticula detected during routine endoscopy can be followed-up without further therapy, whereas symptomatic or large diverticula should be treated surgically by resection. Myotomy should be performed if any motility disorder is evident. Open as well as minimal invasive approach by thoracoscopical surgery is both feasible.

A Dangerous Gastric Bleeding Cause: Dieulafoy'S Lesion

Bleeding is a complication of gastrointestinal vascular malformation and may be an emergency. Dieulafoy's lesion is rare but the aberrant submucosal artery may cause gastrointestinal bleeding. It is most commonly located in the proximal part of the stomach. Endoscopy is used for diagnosis and treatment. Mass lesions, diffuse lesions and severe bleeding may require surgery. Wedge resection or lesion suturing may be selected for gastrointestinal haemorrhage.