Massive gastrointestinal bleeding caused by Dieulafoy's lesion.

Dieulafoy's lesion is an anomaly, difficult to diagnose, consisting of an abnormally dilated submucosal gastric blood vessel that can cause life-threatening gastric hemorrhage. Five patients with Dieulafoy's lesion and massive gastrointestinal bleeding are described. The diagnosis was made by endoscopy in two patients and during operation in the other three. On endoscopy the source of bleeding was localized to the stomach in all patients. This information was important for the operative approach. Conservative treatment failed to prevent rebleeding, and all patients required surgery. In three patients excision of the lesion was performed, and suture only in the other two. The difficulties in diagnosis of the lesion and the surgical options are discussed.