Death due to Gastrointestinal Hemorrhage Associated with Dieulafoy's Lesion

Jaehong Park; Hongil Ha; Minjung Kim

doi:10.7580/kjlm.2014.38.3.113

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Park, Ha, and Kim: Death due to Gastrointestinal Hemorrhage Associated with Dieulafoy's Lesion

Original Article

Korean J Leg Med 2014;38(3):113-115.

Published online: 4 February 2014

DOI: https://doi.org/10.7580/kjlm.2014.38.3.113

Death due to Gastrointestinal Hemorrhage Associated with Dieulafoy's Lesion

Jaehong Park¹, Hongil Ha², Minjung Kim¹

¹Medical Examiner's Office, National Forensic Service, Wonju, Korea

²Division of Forensic Medicine, Busan Institute, National Forensic Service, Yangsan, Korea

책임저자: 김민정(158-707) 서울특별시 양천구 지양로139, 서울과학수사연구소 법의조사과전화: +82-2-2600-4834 FAX: +82-2-2600-4828 E-mail: lillu79@korea.kr

Received 21 July 2014 Revised 13 August 2014 Accepted 25 August 2014

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

Dieulafoy's lesion is a rare condition that may cause intermittent or massive gastrointestinal bleeding. It is characterized by the exteriorization of an arterial vessel into the lumen of the affected organ, generally the upper digestive tract, through an apparently normal mucosa or a small tear or erosion. We report two patients with Dieulafoy's lesions, one in whom the lesion was misdiagnosed as a submucosal tumor and endoscopic biopsy resulted in fatal bleeding.

Keywords: Gastrointestinal hemorrhage, Endoscopy, Death, Autopsy

References

1. Senger JL, Kanthan R. The evolution of Dieulafoy's lesion since 1897: then and now-a journey through the lens of a pediatric lesion with literature review. Gastroenterol Res Pract. 2012; 2012:432517.

2. Baxter M, Aly EH. Dieulafoy's lesion: current trends in diagnosis and management. Ann R Coll Surg Engl. 2010; 92:548–54.

3. Veldhuyzen Van Zanten SJ, Bartelsman JF, Schipper ME, et al. Recurrent massive hematemesis from Dieulafoy vascular malformations: a review of 101 cases. Gut. 1986; 27:213–22.

4. Lee JR, Kim MS, Kim DJ, et al. Gastric bleeding arisen in a patient with situs inversus totalis and large accessory spleen. J Korean Surg Soc. 2010; 78:258–61.

5. Grace PA, O'Sullivan R, Adam AN, et al. Case report: vascular anomaly in Dieulafoy's disease. Clin Radiol. 1991; 44:201–2.

6. Jeong HW, Kim JY, Kim SJ, et al. A case of a jejunal Dieulafoy's lesion mimicking a submucosal tumor. Korean J Gastrointest Endosc. 2008; 37:438–42.

7. Kim JH, Lee YS. Medicine and the law. 2nd ed.Seoul: Epublic;2008. p. 148–55.

Fig. 1.

An arterial vessel is exposed and ruptured into the gastric lumen.

Fig. 2.

Microscopic examination showed the large and tortuous submucosal arteries and the mucosal erosion.

Fig. 3.

There are the biopsy sites and submucosal hemorrhage in the gastric cardia.

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