Dieulafoy Lesion in a Pediatric Patient
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Meylakh Barshay1, Maiya Cowan1,2, Meghan Beucher1,2,3
1The Warren Alpert Medical School of Brown University.
Insights
A rare cause of upper gastrointestinal bleeding (UGIB) in children, Dieulafoy lesions, can be successfully treated with endoscopy. Prompt resuscitation and clinical suspicion are key for managing pediatric UGIB.
Area of Science:
- Pediatric Emergency Medicine
- Gastroenterology
Background:
- Upper gastrointestinal bleeding (UGIB) in children has varied etiologies.
- Accurate diagnosis relies on thorough history and physical examination due to overlapping symptoms.
Purpose of the Study:
- To describe a rare cause of pediatric UGIB: Dieulafoy lesions.
- To enhance understanding of presentation and standard therapeutic approaches for UGIB in children.
Main Methods:
- Retrospective case report.
- Patient presented to a Pediatric Emergency Department with UGIB.
- Diagnosis of Dieulafoy lesion confirmed.
Main Results:
- The patient's UGIB was secondary to a Dieulafoy lesion.
- Treatment involved endoscopy and hemo-clips.
- The patient improved after definitive treatment.
Conclusions:
- Children with UGIB require prompt resuscitation and stabilization.
- Clinicians should consider less common pediatric pathologies like arterial bleeding or malignancy.
- Maintaining a high index of suspicion for rare causes is crucial.
Objective:
Our aim is to describe a rare etiology of an upper gastrointestinal bleeding (UGIB) to help pediatric emergency medicine clinicians improve their understanding of its presentation as well as the standard therapeutic approach to UGIB.
Methods:
This is a retrospective case report of a patient who presented to the Pediatric Emergency Department of Hasbro Children's Hospital and who was found to have a UGIB secondary to a Dieulafoy lesion.
Results:
The etiology of UGIBs varies by geography and patient age but includes esophagitis, Mallory-Weiss tears, gastritis, peptic ulcers, and foreign body ingestion. Given the overlapping presenting symptoms, history and physical are critical to identifying likely etiology and guiding treatment. This patient improved after definitive treatment with endoscopy and hemo-clips.
Conclusions:
Children with symptoms of UGIB should receive prompt resuscitation and stabilization, and clinicians should maintain an index of clinical suspicion for less common pediatric pathologies, such as malignancy or arterial bleeding.
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