Dieulafoy Lesion in a Pediatric Patient.

Abstract

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.