Dieulafoyâs lesion (DL) is an abnormal arterial lesion in the digestive tract. These lesions account for up to 5% of acute upper
gastrointestinal haemorrhages. The stomach is the most frequently comprised, around 75% of all cases. The classic site is the proximal lesser
curvature within 6 cm of the gastroesophageal junction and accounts for approximately 65% of the gastric lesions. The duodenum is the
second most common site for DL and over half of the DL encountered in the duodenum occurs in the bulb.
We report a 21-year-old male, without any relevant his past medical and familiar history. He admitted to the ER with a three hours history
of hematemesis and melena. His physical examination showed a, heart rate of 89 bpm, blood pressure 110/60, no orthostatism, abdominal
examination showed a non-distended abdomen with slight epigastric pain, and no organomegaly. The cardiovascular, respiratory and
neurological examinations were unchanged. The laboratory results showed: Hemoglobin: 11.1 gr/dl, WBC count:
8900 cells/mm3, platelets count: 235,000, LFTs: normal. Abdominal US and a plain abdominal X-ray were also normal. An upper endoscopy
showed a protruding vessel without surrounding venous dilatation, active bleeding or mucosal defect. This vascular lesion was located in
the anterior wall of duodenal bulb.
Last date updated on July, 2014