Gastric Bleeding Due to Dieulafoy’s Lesion, Successfully Treated by Endoscopic Hemoclipping

Gheorghe Ghidirim, Igor Mishin, Eugen Gutsu, Andrei Dolghii

First Department of Surgery “N.Anestiadi” and Laboratory of Hepato-Pancreato-Biliary Surgery, Medical University „N.Testemitsanu“, Emergency Municipal Hospital, Kishinev, Moldova

Abstract

Dieulafoy’s lesion is a rare arterial malformation, which may produce massive gastrointestinal hemorrhage. Most commonly, the lesion occurs in the proximal part of the stomach. We present the case report of a 59-year-old man who was admitted to our emergency unit with massive hematemesis. Urgent endoscopic examination revealed a Dieulafoy’s lesion with spurting bleeding, which was located in the proximal part of the stomach. Bleeding was successfully stopped by endoscopic hemoclipping without any further recurrence. Follow-up endoscopy performed 3 days later showed that the hemoclips became detached, and the protruding artery disappeared. The patient was discharged 4 days after primary endoscopic procedure without any complications. There was no recurrence of the bleeding during the 12 months of observation. Thus, we found that hemoclipping represents an alternative method of achieving endoscopic hemostasis in Dieulafoy’s lesions.

Key words

Dieulafoy’s lesion - endoscopic hemoclipping - gastric bleeding