Gastrointestinal bleeding from Dieulafoy’s lesion: Clinical presentation, endoscopic findings, and endoscopic therapy

Figure 2 An 86-year-old woman who had undergone two esophagogastroduodenoscopies in the prior 2 years for 2 episodes of acute upper gastrointestinal bleeding that had not revealed any upper gastrointestinal lesions, presented with acute onset of melena and an acute hemoglobin level decline from 11. 0 g/dL to 8.6 g/dL. Esophagogastroduodenoscopy revealed an actively oozing, darkly red, 6-8 mm wide, raised, lesion without surrounding erosions or ulceration that was actively oozing along the greater curvature of the gastric body (A), findings characteristic of a Dieulafoy lesion. The lesion was successfully cauterized using 50 watts of argon plasma coagulation at 1 L/min (note probe hovering over cauterized lesion in (B) with cessation of active oozing. The patient was discharged four days later with no evidence of recurrent bleeding during the hospitalization and no further gastrointestinal bleeding during 4 mo of follow-up.