Dieulafoy’s lesion the uncommon cause of upper gastrointestinal bleeding

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Abstract

Upper gastrointestinal bleeding is a challenging condition for the gastroenetrologists. The most common causes in a descending manner are peptic ulcer, erosive disease, variceal bleeding, esophagitis, Mallory–Weiss tears, malignancy, vascular lesions, and no identified causes. Dieulafoy's lesion is a congenital arterial malformation that is associated with brisk bleeding, shock, lower hemoglobin concentration and increased demand for blood transfusion. It is associated with 20% rebleeding rate. It is difficult to diagnose especially in acute severe bleeding cases. Usually it is identified endoscopically as 2–5 mm pigmented protuberance with normal mucosa around or minimal erosions. It can be detected in any part of the gastrointestinal tract but commonly proximal 6 cm of the stomach. It can be managed by epinephrine injection, endoclipping, diathermy, and band ligation.

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