Keywords
Jejunum
Adolescent
How to Cite
Abstract
Introduction: Dieulafoy lesion is an exceptional cause of severe gastrointestinal bleeding in pediatric patients, with few international reports and no prior publications in Latin America. We believe this case, diagnosed and managed at our institution, provides valuable insights for the national and regional pediatric community, emphasizing the importance of timely diagnosis and a multidisciplinary approach in these potentially life-threatening emergencies. Severe gastrointestinal bleeding with hemodynamic compromise in the pediatric age group represents an uncommon emergency, with cases caused by a jejunal Dieulafoy lesion being extremely rare.
Case presentation: a 13-year-old adolescent presented with profuse lower gastrointestinal bleeding (hematochezia) accompanied by hemodynamic compromise. An emergency laparoscopy was initially performed, ruling out suspected Meckel diverticulum. Esophagogastroduodenoscopy (EGD) was normal, and colonoscopy was inconclusive due to poor visualization secondary to blood clots. Mesenteric angiography localized the bleeding site in the jejunum and enabled successful embolization. Subsequent rebleeding occurred, and the lesion was definitively diagnosed via video capsule endoscopy. Jejunal resection with end-to-end anastomosis was performed. Histopathological examination confirmed the diagnosis of a Dieulafoy ulcer. The patient had a favorable recovery, with no bleeding recurrence at the two-year follow-up.
Conclusions: establishing the etiology of severe lower gastrointestinal bleeding with hemodynamic compromise can present a significant diagnostic challenge.
References
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Copyright (c) 2026 Lucia Fein, Gabriela Carro, José Salsamendi, Virginia Curbelo, Claudio Iglesias, Natalia Maciel, Gabriel Giannini