A Case of Dieulafoy Lesion of the Jejunum Presented with Massive Hemorrhage

Min Seok Han; Byung Kyu Park; Sang Hun Lee; Heui Chul Yang; Young Ki Hong; Yoon Jung Choi

doi:10.4166/kjg.2013.61.5.279

Journal List > Korean J Gastroenterol > v.61(5) > 1007087

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Han, Park, Lee, Yang, Hong, and Choi: A Case of Dieulafoy Lesion of the Jejunum Presented with Massive Hemorrhage

Case Report

Korean J Gastroenterol 2013;61(5):279-281.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.61.5.279

A Case of Dieulafoy Lesion of the Jejunum Presented with Massive Hemorrhage

Min Seok Han, Byung Kyu Park, Sang Hun Lee, Heui Chul Yang¹, Young Ki Hong², Yoon Jung Choi³

Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea

¹Department of Diagnostic Radiology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea

²Department of General Surgery, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea

³Department of Pathology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea

Correspondence to: Byung Kyu Park, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 410-719, Korea. Tel: +82-31-900-0645, Fax: +82-31-900-0049, E-mail: bkpark@nhimc.or.kr

Received 14 September 20125 October 2012 Accepted 8 October 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The Dieulafoy lesion is a rare cause of severe gastrointestinal hemorrhage. Although it may occur anywhere in the gastrointestinal tract, the lesion is most commonly located in the stomach, and the small bowel is an extremely uncommon site. Since Dieulafoy lesion in the small bowel is difficult to access by endoscopy, it seems impossible to diagnose and treat by initial endoscopy unlike the lesions in stomach. We experienced a case of Dieulafoy lesion of jejunum with massive hemorrhage in 54-year-old male. Active jejunal bleeding was shown by computed tomography scan and mesenteric angiography. Partial resection of the jejunum was performed. Final pathologic finding revealed Dieulafoy lesion of the jejunum.

Keywords: Dieulafoy lesion, Gastrointestinal Hemorrhage, Jejunum

References

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Fig. 1.

Axial section of CT scan showing bleeding focus in the jejunum (arrow) at arterial phase (A), and contrast leakage into jejunum (arrow) at venous phase (B). (C) CT angiography showing arterial bleeding on jejunum (arrow).

Fig. 2.

Mesenteric angiography showed ectatic artery accompanied by contrast extravasation and staining (arrow) at the jejunum level.

Fig. 3.

A microscopic finding of resected bowel specimen showed erosive mucosa in contact with a large tortuous submucosal vessel filled with thrombi (H&E, ×125).

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