Department of Pathology and Laboratory Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon SK, Canada S7N 0W8.
Published: August 2012
AI Article Synopsis
Article Abstract
Background. In 1897, Dieulafoy was the first to characterize a gaping arteriole within the gastric mucosa causing massive hematemesis, designating it as "exulceratio simplex." A hundred years later, this vascular abnormality, now commonly referred to as a "Dieulafoy lesion," has been identified through the entire gastrointestinal tract and the bronchus. Objectives and Methods. As the original findings have been subjected to revisions and modifications by modern authors, Dieulafoy's original paper was reviewed and analyzed. The evolution of the current usage of "Dieulafoy's lesion" in the literature has been summarized with comparisons to the original report. Additionally, an index case of a 10-year-old female with a gastric "exulceratio simplex" is reported with a review of previously reported paediatric Dieulafoy lesions. Conclusions. The term "Dieulafoy lesion" in modern literature no longer adheres to the initial conclusions with regards to its origin, demographics, and presenting symptoms. Dieulafoy lesions remain a rare cause of gastrointestinal bleeding that can cause life-threatening haemorrhages in children.
A 64-year-old man involved in a low-speed vehicle crash was found at autopsy to have altered blood extending from his stomach to his rectum. Within the stomach a small arterial vessel opened onto the mucosa of the posterior wall of the antrum adjacent to the pylorus with no adjacent mucosal ulceration or malignancy. Histologic sections showed the typical appearances of a Dieulafoy lesion with a tortuous small arteriole within the submucosa extending to the gastric lumen with an overlying cap of recently formed clot.
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.
Introduction: The Dieulafoy lesion (DL) is a rare cause of gastrointestinal bleeding. Advances in the endoscopy field have allowed an increased rate of detection and therapeutic efficacy. However, doubts remain about the most effective hemostatic approach, the affecting variables of therapeutic failure, and early relapse, as well as in the long-term follow-up.
Background. In 1897, Dieulafoy was the first to characterize a gaping arteriole within the gastric mucosa causing massive hematemesis, designating it as "exulceratio simplex." A hundred years later, this vascular abnormality, now commonly referred to as a "Dieulafoy lesion," has been identified through the entire gastrointestinal tract and the bronchus.
