All issues > Volume 47(3); 2004

Case Report

Korean J Pediatr. 2004;47(3):343-346. Published online March 15, 2004.

A Case of Dieulafoy's Lesion in Duodenal Bulb

Jung Woo JW Rhim¹, Young Seok YS Kim², Jae Ock JO Park¹

¹Department of Pediatrics, College of Medicine, Soonchunhyang University, Bucheon, Korea
²Department of Internal Medicine, College of Medicine, Soonchunhyang University, Bucheon, Korea

Correspondence Jae Ock JO Park ,Email: jop50@schbc.ac.kr

Abstract

Dieulafoy's lesion is an uncommon cause of recurrent massive gastrointestinal bleeding resulting from an abnormally large submucosal artery that protrudes through a small mucosal defect. Incidence of Dieulafoy's lesion as a source of upper gastrointestinal bleeding ranges from 0.3 to 6.7% in adults. But recently, the incidence is on an increasing trend by advanced endoscopic diagnostic technique. Lesions may occur anywhere in the gastrointestinal tract but are typically located within 6 to 10 cm of the gastroesophageal junction, generally along the lesser curvature of the stomach. Lesions are life threatening because bleeding is often massive and recurrent. The mean age of presentation is in the fifth decade and patients of pediatric age are extremely rare. We report a 12-year-old male patient who had Dieulafoy's lesion, diagnosed by emergency gastrointestinal endoscopy. Endoscopic finding was active bleeding from Dieulafoy's lesion in the duodenal second portion. Bleeding was controlled with endoscopic hemoclipping without complication or recurrence.

Keywords :Dieulafoy's lesion, Duodenum, Endoscopic hemoclipping, Children, Gastrointestinal hemorrhage