Clin Endosc.  2024 Jul;57(4):552-554. 10.5946/ce.2023.231.

Jejunal Dieulafoy’s lesion resembling subepithelial mass resulting in profound gastrointestinal hemorrhage

• Chaemsupaphan T
• Geeratragool T
• Angkathunyakul N
• Phothisirisakulwong A
• Maneerattanaporn M

• KMID: 2558115
• DOI: http://doi.org/10.5946/ce.2023.231

Figure

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  Fig. 1. Push enteroscopy reveals a 2.5 cm round subepithelial mass with a large central defect covered by an adherent clot in the proximal part of the jejunum.

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  Fig. 2. (A) Arterial phase computed tomographic angiography shows a round-shaped 2×1.4 cm arterial enhancing lesion in the proximal jejunum (arrow) adjacent to hemostatic clip (*) without active contrast extravasation within bowel loops. (B) The angiography of the jejunal branch of the superior mesenteric artery reveals an accumulation of contrast media at the proximal jejunum (arrow) near the hemostatic clip (*), which is supplied by multiple small jejunal branches. No demonstrable active contrast extravasation is seen in the study.

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  Fig. 3. (A) The gross lesion reveals a large thrombus within the submucosa. (B) The histopathology reveals a submucosal persistent-caliber artery, dilated with a recent thrombus (*) (hematoxylin and eosin stain, ×10). The overlying mucosal defect (arrow) is connected to the lesion. (C) The vascular wall of the lesion (dotted line) is exceedingly thickened compared to the normal submucosal artery (*) (hematoxylin and eosin stain, ×200).

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