Dieulafoy’s lesion of jejunum presenting as an obscure gastrointestinal bleeding: a case report

Abstract

Obscure gastrointestinal bleeding has been designated as bleeding of unknown origin that persist
or recurs after a negative initial or primary endoscopy (colonoscopy and upper endoscopy). We
present a case of 16 years old male who was admitted at our hospital with presentation of black
tarry hard foul-smelling stool associated with weakness, dizziness and loss of consciousness for
10-15 minutes. Physical examination showing pallor. Upper GI Endoscopy, colonoscopy and double
balloon Enteroscopy (DBE) failed to find out the cause of bleeding whereas, CT angiography shows
a prominent submucosal vessel with blush of contrast enhancement seen at mid-jejunum and
suggestive of a Dieulafoy’s lesion. As the lesion was not identified properly during both anterograde
and retrograde Double Balloon Enteroscopy we decided to go for the conservative management
and treated the patient on close monitoring.