Melena Secondary to Duodenal Dieulafoy’s Lesion: A Rare Case Report

• Main Authors: Uthamalingam Murali, Mohammad Azhar Anis Ahmad, Ahmad Rahuddin Bin Abdul Hali, Muhamad Afiq Hamidin
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2017-11-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: blackish coloured stools; haemoclip; upper gastrointestinal bleeding
• Online Access: https://jcdr.net/articles/PDF/10908/28515-CE(RA1)_F(GG)_(PK_PrG_GG)_PFA(MJ_AP).pdf

Melena is one of the presenting feature of Upper Gastrointestinal Bleeding (UGIB). Melena due to Dieulafoy’s lesion in the duodenum is one of the obscure causes of Gastrointestinal Bleeding (GIB) and is a rare but life threatening entity. We report a unique case of Dieulafoy’s lesion in a 74-year-old male patient with premorbid condition of diabetes who presented with two episodes of blackish coloured stools, filling up the entire toilet bowl. No other symptoms of either abdominal pain, vomiting of blood, fever or any intake of medications were noted. Upper Gastro-Intestinal (UGI) endoscopy revealed abnormal vessels at D1/D2 of C loop duodenum with normal mucosa consistent with Dieulafoy’s lesion along with active bleeding. Haemoclips were applied to the duodenal Dieulafoy’s lesion and patient recovered well. This case was reported for the first time from Malaysia.