Breaking Patterns: A Case of Dieulafoy Lesion in a Young Patient Without Comorbid Conditions

TL;DR

A rare Dieulafoy lesion causing severe stomach bleeding was found in a young, healthy 18-year-old patient.

Contribution

This case report highlights an unusual occurrence of a Dieulafoy lesion in a young individual without health issues.

Findings

An 18-year-old with no comorbidities presented with a Dieulafoy lesion causing upper gastrointestinal bleeding.

The patient's lesion was diagnosed and treated within 24 hours using endoscopic hemostasis.

Ibuprofen use and a prior splenic artery embolization are proposed as potential contributing factors.

Abstract

A Dieulafoy lesion is an abnormal artery located in the gastric submucosa that represents a rare cause of upper gastrointestinal bleeding. These lesions typically present as massive hemorrhages in older patients, with multiple medical comorbidities. The lesions are diagnosed with endoscopy and treated with hemostasis by clip placement or coagulation. This case report is that of a rare presentation of this rare condition in a younger 18-year-old patient with no medical comorbidities. He presented with hematemesis, melena, and syncope in the setting of ibuprofen self-treatment for a recent upper viral illness. This medication use is a proposed inciting factor for the bleeding lesion, though he had a history of a splenic artery embolization following a remote motor vehicle accident, which could represent a mechanism for a rare acquired lesion. A gastroenterologist was consulted and assisted in the diagnosis and management of this patient. His lesion was identified and treated within 24 hours of his presentation.

Figures