The evolution of Dieulafoy's Lesion since 1897: Then and now-a journey through the lens of a pediatric lesion with literature review

Abstract

Background. In 1897, Dieulafoy was the first to characterize a gaping arteriole within the gastric mucosa causing massive hematemesis, designating it as exulceratio simplex. A hundred years later, this vascular abnormality, now commonly referred to as a Dieulafoy lesion, has been identified through the entire gastrointestinal tract and the bronchus. Objectives and Methods. As the original findings have been subjected to revisions and modifications by modern authors, Dieulafoy's original paper was reviewed and analyzed. The evolution of the current usage of Dieulafoy's lesion in the literature has been summarized with comparisons to the original report. Additionally, an index case of a 10-year-old female with a gastric exulceratio simplex is reported with a review of previously reported paediatric Dieulafoy lesions. Conclusions. The term Dieulafoy lesion in modern literature no longer adheres to the initial conclusions with regards to its origin, demographics, and presenting symptoms. Dieulafoy lesions remain a rare cause of gastrointestinal bleeding that can cause life-threatening haemorrhages in children. © 2012 Jenna-Lynn Senger and Rani Kanthan.