Clin Endosc.  2012 Nov;45(4):440-443.

Two Cases of Ileal Dieulafoy Lesion with Massive Hematochezia Treated by Single Balloon Enteroscopy

• Choi YC
• Park SH
• Bang BW
• Kwon KS
• Kim HG
• Shin YW

Abstract

Ileal Dieulafoy lesion is an unusual vascular abnormality that can cause gastrointestinal bleeding. It can be associated with massive, life-threatening hemorrhage and requires urgent angiographic intervention or surgery. Ileal Dieulafoy lesion is hard to recognize due to inaccessibility and normal-appearing mucosa. With advances in endoscopy, aggressive diagnostic and therapeutic approaches including enteroscopy have recently been performed for small bowel bleeding. We report two cases of massive ileal Dieulafoy lesion bleeding diagnosed and treated successfully by single balloon enteroscopy with a review of the literature.

Keyword

Gastrointestinal hemorrhage; Ileum; Dieulafoy lesion; Single balloon enteroscopy

MeSH Terms

Endoscopy
Gastrointestinal Hemorrhage
Hemorrhage
Ileum
Mucous Membrane

Figure

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  Fig. 1 Angiographic finding of superior mesenteric artery. It showed the fine feeding branch from the right ileocolic artery (arrow) and bowel lumen filled with contrast media at the terminal ileum (arrowhead).

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  Fig. 2 Single-balloon enteroscopic findings. (A) It revealed Dieulafoy lesion on the distal ileum. (B) Hemoclipping was performed on the exposed vessel.

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  Fig. 3 Capsule endoscopic finding. It revealed no abnormal lesions except the previously placed hemoclips.

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  Fig. 4 Single-balloon enteroscopic findings. (A) It showed the active bleeding at a narrow point of normal-appearing mucosa (arrow). (B) Hemoclip hemostasis was performed until the vessel stopped bleeding.

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