Dieulafoy's Lesion in the Esophagus Causing Gastrointestinal Bleeding: A Concise Review

Dieulafoy's lesion (DL) is an uncommon cause of life-threatening gastrointestinal (GI) bleeding. It can occur in any part of the GI tract, including the stomach, duodenum, colon, and esophagus. Dieulafoy's lesion in the esophagus (DLE) is an exceedingly rare entity, with only 23 case reports/series (27 patients) reported to date. We performed a systematic search of published case reports on DLE in PubMed, Google Scholar, and Embase, from inception through January 2024. The search terms for the review were "Dieulafoy's lesion," "esophagus," "oesophagus," "hematemesis," "melena," "hematochezia," and "gastrointestinal bleeding." Articles were eligible for inclusion in the study if they were published in English, described a case of DLE noted on endoscopy or histopathology, and were available as full text. Our literature search yielded 23 articles consisting of 27 patients. Of the 27 patients, eight (30%) were female and 19 (70%) were male. The patients' age ranged from 13 years to 87 years, with an average age of 54.1 years. Twenty-five patients (92.6%) presented with hematemesis and melena as chief complaints. DLE was found in the distal esophagus in 19/27 (70.4%) of the patients and the mid-esophagus in 6/27 (22.2%) of the patients. Two patients had no information about the lesion site. Endoscopic hemoclips were employed in 12 (44.4%) patients, endoscopic band ligation (EBL) in six and electrocautery was used in one patient. Early diagnosis and prompt treatment are crucial for managing DLE, as they can cause recurrent bleeding and potentially lead to complications or death.