Curriculum · Gastroenterology
Dieulafoy lesion
What it is
A Dieulafoy lesion is a submucosal dilatation of the blood vessel in the proximal stomach at the lesser curvature: a large caliber submucosal artery, exposed, with no ulcer. Its typical location is the lesser curvature of the proximal stomach, 1-6 cm from the GE junction. It bleeds profusely and is an uncommon but important cause of massive, intermittent upper GI bleeding.
Causes and risk
It is named among the causes of upper GI bleeding, in a list that runs peptic ulcer, esophageal varices, Mallory Weiss, gastritis, AV malformation and Dieulafoy lesion. That list is not the variceal division. Upper GI bleeding is divided into variceal and non variceal, and the arterial nonvariceal group of the etiology table holds peptic ulcer disease, Mallory-Weiss tear, hemorrhagic gastritis, neoplasm, inflammatory pseudoaneurysms, aortoduodenal fistula, iatrogenic injury, trauma, hemobilia and hemosuccus pancreaticus, against a venous variceal group of cirrhosis, Budd-Chiari syndrome and splenic vein thrombosis. It is also listed among the etiologies of lower GI bleeding, after the two most common ones, diverticulosis and angiodysplasia.