Moreira-Pinto João, Raposo Carlos, Teixeira da Silva Vitor, Curado João, Barbosa Eva, Honavar Minal, Flemming Oliveira José
Serviço de Cirurgia Pediátrica, Hospital de Crianças Maria Pia, Rua da Boavista, 827, Porto 4000-111, Portugal.
Pediatr Surg Int. 2009 Jul;25(7):641-2. doi: 10.1007/s00383-009-2383-1. Epub 2009 Jun 2.
Dieulafoy's lesions are rare and usually present in the stomach. There are only 18 cases of jejunal Dieulafoy's lesion reported. It can present as a massive gastrointestinal bleed and a high grade of suspicion is necessary for a quick and effective approach. The authors present the case of a 14-year-old adolescent with a sudden onset of hematochezia and shock. The high and low endoscopies as well as the arteriography were all inconclusive. An exploratory laparotomy was undertaken in the first 24 h of hospital admission. A review of the small bowel by advancing soft bowel clamps in a sequential manner revealed a bleeding lesion in the jejunum. The histological exam showed a Dieulafoy's lesion.
