Dieulafoy lesion As a Cause of Upper Gastrointestinal Bleeding скачать в хорошем качестве

Dieulafoy lesion As a Cause of Upper Gastrointestinal Bleeding

Dieulafoy lesion is a rare but potentially life-threatening cause of upper gastrointestinal bleeding (UGIB). It involves a large, tortuous submucosal artery that protrudes through a tiny mucosal defect, leading to sudden and often massive bleeding—even in the absence of an ulcer. 🩸 What Makes It Unique Unlike typical ulcers, Dieulafoy lesions don’t involve widespread mucosal erosion. The bleeding arises from a caliber-persistent artery—a vessel that fails to taper as it approaches the mucosa. Most commonly found in the stomach, especially along the lesser curvature near the gastroesophageal junction, but can also occur in the duodenum, colon, or esophagus. ⚠️ Clinical Presentation Sudden hematemesis (vomiting blood) Melena (black, tarry stools) Hemodynamic instability in severe cases Often occurs in older adults, with a male predominance 🔍 Diagnosis Upper endoscopy is the gold standard and may reveal a pinpoint mucosal defect with active arterial bleeding or a visible vessel. CT angiography or angiography may be used if endoscopy is inconclusive or bleeding is brisk. 💉 Treatment Endoscopic therapy is first-line and highly effective: Thermal coagulation Hemoclips Injection therapy (e.g., epinephrine) Angiographic embolization or surgical resection may be needed in refractory cases. #Gastrointestinal