Endoscopic Band Ligation

Dieulafoy’s 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.

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Last date updated on April, 2024