Endoscopic treatment of Dieulafoy's lesion of the duodenum

Dieulafoy's lesion is an often unrecognized cause of catastrophic upper gastrointestinal hemorrhage, typically seen in otherwise asymptomatic patients. Although the lesion is most often found in the stomach, it has rarely been reported to occur in the jejunum and duodenum. Endoscopic treatment has recently been attempted to arrest the bleeding from these lesions, when found in the stomach, with satisfactory results. We report a patient with a bleeding duodenal Dieulafoy lesion who was successfully treated with endoscopic injection of epinephrine (1:10,000) and electrocoagulation. Endoscopic treatment of Dieulafoy's lesion should be attempted before surgery and, as in other causes of acute nonvariceal hemorrhage, be considered the treatment of choice.