Posters

Discipline Track

Community/Public Health

Abstract

Introduction: Dieulafoy's lesion is a rare and potentially life-threatening condition. It accounts for 1.5 to 2% of reported acute gastrointestinal (GI) bleeding and has been linked to alcoholism and antiplatelet drug use. Unfortunately, the exact prevalence in the Hispanic population is unknown.

Case report: A 40-year-old man with a history of alcohol abuse and liver cirrhosis presented to the emergency room with complaints of frank hematemesis of 1 day duration. He was found to be diaphoretic, tachycardic (118), hypotensive (BP: 77/49), Hb - 6.2g/dl and with an INR of 1.92 (N: 0.8-1.2). Initial working diagnosis of esophageal varices was made, and he was resuscitated with packed red blood cells, plasma, and platelets. He was later scheduled for an EGD, and endoscopic findings revealed a Dieulafoy’s lesion in the cardia of the patient’s stomach. The lesion was injected with epinephrine and endoclipped. Unfortunately, despite these interventions, the patient passed the same day due to unresponsive hemorrhagic shock.

Conclusion: The treatment of Dieulafoy’s lesion consists of therapeutic endoscopy, angiographic intervention, and surgical evaluation if refractory to previously mentioned methods. Due to the potentially life-threatening nature of Dieulafoy’s lesions, prompt recognition and appropriate management should be of utmost importance.

Presentation Type

Poster

Academic Level

Resident

Mentor/PI Department

Internal Medicine

COinS
 

Dieulafoy's lesion as a cause of upper gastrointestinal bleeding in a Hispanic male with alcoholic liver cirrhosis

Introduction: Dieulafoy's lesion is a rare and potentially life-threatening condition. It accounts for 1.5 to 2% of reported acute gastrointestinal (GI) bleeding and has been linked to alcoholism and antiplatelet drug use. Unfortunately, the exact prevalence in the Hispanic population is unknown.

Case report: A 40-year-old man with a history of alcohol abuse and liver cirrhosis presented to the emergency room with complaints of frank hematemesis of 1 day duration. He was found to be diaphoretic, tachycardic (118), hypotensive (BP: 77/49), Hb - 6.2g/dl and with an INR of 1.92 (N: 0.8-1.2). Initial working diagnosis of esophageal varices was made, and he was resuscitated with packed red blood cells, plasma, and platelets. He was later scheduled for an EGD, and endoscopic findings revealed a Dieulafoy’s lesion in the cardia of the patient’s stomach. The lesion was injected with epinephrine and endoclipped. Unfortunately, despite these interventions, the patient passed the same day due to unresponsive hemorrhagic shock.

Conclusion: The treatment of Dieulafoy’s lesion consists of therapeutic endoscopy, angiographic intervention, and surgical evaluation if refractory to previously mentioned methods. Due to the potentially life-threatening nature of Dieulafoy’s lesions, prompt recognition and appropriate management should be of utmost importance.

 

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