Dieulafoy's lesion of duodenum: a case report.
BACKGROUND
Dieulafoy's lesion is an uncommon but important cause of recurrent upper gastrointestinal bleeding. Extragastric location of Dieulafoy's lesion is rare. We report two cases of Dieulafoy's lesion of the duodenum and discuss the management of this extremely uncommon entity.


METHODS
Two cases of massive upper gastro-intestinal bleeding in young adults due to Dieulafoy's lesion of the duodenum are reported. Endoscopic diagnosis was possible in both cases. Hemostasis was achieved successfully by endoscopic adrenaline injection. The endoscopic appearance, pitfalls in the diagnosis and management of this rare lesion are discussed.


CONCLUSIONS
Endoscopic diagnosis of extragastric Dieulafoy's lesion can be difficult because of the small size and obscure location of the lesion. Increased awareness and careful and early endoscopic evaluation following the bleeding episode are the key to accurate diagnosis. Adrenaline injection is one of the important endoscopic modalities for control of bleeding.
Ibrarullah
Mohammed
M
Dept. of Gastroenterology, Sri Venkateswara Institute of Medical Sciences, Tirupati 517507 (AP), India. m_ibrarullah@yahoo.co.in
Wagholikar
Gajanan D
GD
D000328:Adult; D001158:Arteries / Q000002:abnormalities; D004386:Duodenum / Q000098:blood supply*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply*; D008297:Male