Approximately 75% of Dieulafoy's lesions occur in the upper part of the stomach within 6 cm of the gastroesophageal junction, most commonly in the lesser curvature.
As a result of restricting our study to non-variceal bleeding and a high referral rate from other hospitals there is a seemingly high incidence of Dieulafoy's lesion in our patients.
Some authors have also described significant concurrent morbidity or remarkable past medical history, while others have described the 'typical patient' with Dieulafoy's lesion to have an unremarkable past medical history.
Many bleeding lesions have been successfully clipped, including bleeding peptic ulcers, Mallory-Weiss tears of the esophagus, Dieulafoy's lesions, stomach tumours, and bleeding after removal of polyps.
Another patient experienced a recurrence of Dieulafoy's lesion half a year after an initially successful endoscopic approach and had surgical intervention without a further endoscopic attempt (histologically proved case of Dieulafoy's disease, see the Figure).
Dieulafoy's Lesions are characterized by a single large tortuous arteriole in the submucosa which does not undergo normal branching or a branch with caliber of 1-5 mm (more than 10 times the normal diameter of mucosal capillaries).
Three patients had a history of previous bleeding from ulcers of the duodenum or stomach, one patient experienced anastomosal bleeding with a history of gastric resection, one patient had a Dieulafoy's lesion treated conservatively in another hospital with recurrent bleeding episodes within one year before admission.