Jejunal Dieulafoy´s lesion. Case report and literature review

Abstract

Dieulafoy´s lesion is a rare cause of gastrointestinal bleeding, especially of low gastrointestinal bleeding. It consists of a large-caliber arterial vessel in the submucosa of the digestive tract, which at some point undergoes erosion of the overlying mucosa and the vascular wall, causing intermittent and potentially fatal hemorrhage. The case described below is the first of Dieulafoy´s lesion located in the jejunum reported in the Honduran medical literature, and illustrates its clinical presentation and the anatomopathological findings found in the autopsy of a 42-year-old male patient who died from hypovolemic shock. The diagnosis of Dieulafoy´s lesion is histopathological and is made in surgical resections or autopsy, however, its endoscopic characteristics allow it to be diagnosed with some safety and treated, saving the life of the patient without requiring other major procedures In the present case, the patient could not be submitted to endoscopy because he remained hemodynamically unstable, unable to be treated, nor to determine the region of bleeding to guide the surgeon in the laparotomy. The aim of this publication is to communicate about a rare cause of gastrointestinal bleeding that should always be considered in the differential clinical diagnosis and the findings found in the autopsy, because they are not frequently reported in literature..