A Rare Cause of Gastrointestinal Bleeding in a 65-Year-Old Man with History of Polycythemia Vera

Upper gastrointestinal bleeding due to Dieulafoy's lesion of the stomach: a rare case report

Dieulafoy's lesion is a life-threatening and rare vascular malformation of the submucosal vessel that protrudes to the mucosa of the gastrointestinal tract. The vessel is abnormally dilated, and if it ruptures, it can cause severe acute gastrointestinal bleeding. We report an upper GI bleeding case due to Dieulafoy's lesion in the gastric fundus of the stomach in a 76-year-old female. The patient presented with hematemesis and melena associated with anemia. An esophagogastroduodenoscopy (OGD) was performed which showed profuse pulsatile bleeding at the gastric fundus. Following that, gastrotomy confirmed the diagnosis of Dieulafoy's lesion. Endoscopy is the main diagnostic and therapeutic tool for Dieulafoy's lesion. Endoscopic treatment includes injective, ablative and mechanical therapies. The majority of cases are treated endoscopically, while in some cases, surgical intervention is deemed to be necessary as it is currently the only definitive treatment of Dieulafoy's lesion.

Use of Over-the-Scope Clip as First Choice to Treat Gastric Dieulafoy Lesions

Dieulafoy lesion is a rarely seen, superficial vascular lesion of the gastric mucosa that can lead to severe and recurrent bleeding which can be life-threatening. It is characterized by massive hemorrhages that can occur as a result of protrusion of a large artery from a submucosal defect. Endoscopic injection and mechanical and thermal methods are frequently used in traditional treatment. Herein, we presented a 61-year-old women who was admitted with upper gastrointestinal hemorrhage owing to Dieulafoy lesion who was successfully treated with over-the-scope clip as the first choice of treatment.