Common Causes Rare Causes Under 40 years old Over 40 years old Henoch--Schoenlein purpura Inflammatory bowel Angioectasia Amyloidosis disease Dieulafoy
lesions Osler--Weber--Rendu syndrome Neoplasia Neoplasia Hemobilia Meckel diverticulum NSAID ulcers Aortoenteric fistula Polyposis syndromes Small bowel varices and (e.g.
To the Editor: Dieulafoy
's disease is characterized by the tortuous arteries of abnormally large caliber running within the submucosa, which is susceptible to ulceration and bleeding.
Peptic ulcers, angiodysplasias and Dieulafoy
's lesions also result in gastrointestinal bleeding4,25.
First described in 1898 by Dieulafoy
, DL was identified in two patients with fatal upper gastrointestinal hemorrhage without ulceration.
An initial urgent endoscopy revealed a bleeding Dieulafoy
lesion, which was immediately clipped.
Distinctive aspects of peptic ulcer disease, Dieulafoy
's lesion, and Mallory-Weiss syndrome in patients with advanced alcoholic liver disease or cirrhosis.
The reasons for GI bleeding included diverticulosis (n=19, 20.5%), unknown (n=14, 15.9%), diverticulitis (n=12, 13.6%), ulcer (n=10, 11.4%), tumor (n=9, 10.2%), arteriovenous malformation (n=6, 6.8%), colitis (n=6, 6.8%), anticoagulation (n=3, 3.4%), ischemia (n=3, 3.4%), inflammatory bowel disease (n=3, 3.4%), vasculitis (n=2, 2.3%), Meckel's diverticulum (n=1, 1.1%), and jejunal Dieulafoy
lesion (n=1, 1.1%).
ulcer is a rare lesion, with obscure etiology, affecting predominantly middle-aged men; in most cases, there is an associated renal or cardio-pulmonary pathology, a history of antiplatelet therapy or NSAID.
In the group of patients with non-variceal bleeding, 42.8% had bleeding ulcer, while 57.2% had nonulcer bleeding (Mallory-Weis tear, angiomata, Dieulafoy
's lesion, malignancy, acute erosive gastropathy, reflux esophagitis, portal hypertensive gastropathy, arterial enteric fistula).
's lesion is a rare and potentially life-threatening cause of gastrointestinal bleeding.
Aim and background: Dieulafoy
lesion (DL) represents a rare, but important cause of major upper digestive bleeding, especially in elders.
"I discovered he had a rare condition called Dieulafoy
's lesion," he said.