{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T20:28:23Z","timestamp":1782764903098,"version":"3.54.5"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T00:00:00Z","timestamp":1592956800000},"content-version":"vor","delay-in-days":175,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Dieulafoy lesions are enlarged atypical submucosal vessels that erode the superimposing epithelium in the absence of a primary ulcer. They occur predominantly in the gastric mucosa; however, cases have been seen throughout the gastrointestinal (GI) tract, and rarely, the jejunum. These lesions can cause massive GI hemorrhage leading to shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We present a healthy 19-year-old male who arrived at our institution\u2019s emergency department with multiple episodes of hematemesis and hematochezia that began earlier that morning. The patient was resuscitated and underwent a computerized tomographic (CT) angiography that did not identify any areas of active extravasation. The patient was then taken for an emergent upper and lower endoscopy that was inconclusive. He was subsequently sent for a tagged red blood cell scan, which demonstrated active bleeding in the proximal jejunum. Shortly thereafter, the patient began to decompensate requiring additional blood products and vasopressors. The decision was made for immediate operative intervention, which identified the bleeding Dieulafoy lesion (confirmed by histopathology) in the jejunum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Dieulafoy lesions are rare with an initial presentation of upper or lower GI bleeding, generally treated with endoscopic intervention. They are predominately found in the stomach or duodenum. When no clear source is identified by endoscopy, further diagnostic testing may be of value. Various imaging modalities exist; however, CT angiography or radionuclide scanning are particularly sensitive and can be beneficial in localizing the bleed when preparing for operative intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>With advances in endoscopic techniques, surgical intervention is rarely performed for a Dieulafoy lesion. If endoscopy is unsuccessful, additional imaging can be obtained to localize the source of bleeding. However, in emergent cases, when additional imaging cannot be obtained due to lack of time or resources, adequate resection of the lesion should be performed for complete resolution of the disease process. Based on the case presentation and pathologic findings, this case provides further insight into Dieulafoy lesions and the rare need for surgical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.06.098","type":"journal-article","created":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T11:53:10Z","timestamp":1593085990000},"page":"541-545","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["A Jejunal Dieulafoy Lesion"],"prefix":"10.1097","volume":"72","author":[{"given":"Misbah","family":"Yehya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oksana","family":"Mayovska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Flick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zbigniew","family":"Moszczynski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-120-20260114","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1067\/mge.2003.328","article-title":"Dieulafoy\u2019s lesion","volume":"58","author":"Lee","year":"2003","journal-title":"Gastrointest. Endosc"},{"key":"R2-120-20260114","first-page":"276","article-title":"The endosonographic appearance of a Dieulafoy\u2019s lesion","volume":"89","author":"Squillace","year":"1994","journal-title":"Am. J. Gastroenterol"},{"key":"R4-120-20260114","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1067\/mge.2000.108040","article-title":"Bleeding Dieulafoy\u2019s lesions and the choice of endoscopic method: comparing the hemostatic efficacy of mechanical and injection methods","volume":"52","author":"Chung","year":"2000","journal-title":"Gastrointest. Endosc"},{"key":"R5-120-20260114","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1055\/s-2003-38780","article-title":"The usefulness of endoscopic hemoclipping for bleeding Dieulafoy lesions","volume":"35","author":"Park","year":"2003","journal-title":"Endoscopy"},{"key":"R6-120-20260114","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/S0016-5107(05)01583-X","article-title":"Delayed fatal hemorrhage after endoscopic band ligation for gastric Dieulafoy\u2019s lesion","volume":"62","author":"Chen","year":"2005","journal-title":"Gastrointest. Endosc"},{"key":"R7-120-20260114","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/S0016-5107(05)00557-2","article-title":"Safety of band ligator use in the small bowel and the colon","volume":"62","author":"Barker","year":"2005","journal-title":"Gastrointest. Endosc"},{"key":"R9-120-20260114","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1148\/radiol.2283020756","article-title":"Sheiman RGDetection of active colonic hemorrhage with use of helical CT: findings in a swine model","volume":"228","author":"Kuhle","year":"2003","journal-title":"Radiology"},{"key":"R10-120-20260114","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0001-2998(03)00033-3","article-title":"Acute gastrointestinal bleeding","volume":"33","author":"Zuckier","year":"2003","journal-title":"Semin. Nucl. Med"},{"key":"R11-120-20260114","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S0016-5107(92)70513-6","article-title":"Clinical features and endoscopic management of Dieulafoy\u2019s disease","volume":"38","author":"Stark","year":"1992","journal-title":"Gastrointest. Endosc"},{"key":"R12-120-20260114","first-page":"225","article-title":"Massive lower gastrointestinal bleeding from a jejunal Dieulafoy lesion","volume":"30","author":"Kozan","year":"2014","journal-title":"Ulus. Cerrahi Derg"},{"key":"R13-120-20260114","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ijsu.2018.10.028","article-title":"The SCARE 2018 statement: updating consensus surgical CAse REport (SCARE) guidelines","volume":"60","author":"Agha","year":"2018","journal-title":"Int. J. Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220305010?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220305010?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.06.098","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:12:02Z","timestamp":1768396322000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.06.098"}},"subtitle":["Rare Case Necessitating Surgical Intervention"],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":11,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.06.098","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}