Medical Science: Updates and Prospects Vol. 7

Dieulafoy's lesion is a rare but serious cause of gastrointestinal bleeding, typically affecting older adults. It involves an aberrant arteriole eroding the gastric mucosa, resulting in severe, recurrent bleeding that poses diagnostic and management challenges. A review of the literature revealed that, since the original description of Dieulafoy’s lesion over 100 years ago, only 280 cases had been reported worldwide up to 2010. From Bangladesh, only two cases have been reported, both described recently. This study reported the case of a female in her mid-sixties who presented with melena. She had coexisting left heart failure and chronic kidney disease. Initial and repeat upper GI endoscopies were negative, but a subsequent emergency endoscopy revealed bleeding from two sites near the gastroesophageal junction. Hemostasis was achieved with argon plasma coagulation, and Dieulafoy’s lesion was identified as the cause of her recurrent GI bleeding. This case highlights the importance of considering Dieulafoy’s lesion (DL) in the differential diagnosis of gastrointestinal haemorrhage, as it can cause significant morbidity, weight loss, and may be missed during initial investigations. Therefore, DL should be emphasised in postgraduate medical curricula and always considered in patients presenting with GI bleeding.