{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:16:52Z","timestamp":1756383412329,"version":"3.40.4"},"reference-count":18,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,8,26]]},"abstract":"<jats:p>A 74-year-old man on warfarin for aortic valve replacement presented with recurrent episodes of melaena. An initial oesophagogastroduodenoscopy (OGD) was normal, as were red cell scanning and colonoscopy. It was a third OGD that revealed the cause of the melaena\u2014a vascular lesion in the duodenum, at the junction between D1 and D2. An extragastric Dieulafoy's lesion was diagnosed, and the lesion was injected with epinephrine and tattooed. Over the following months, episodes of bleeding recurred despite further attempts at injection. Percutaneous radiologically assisted embolisation of the gastroduodenal artery, and eventually duodenotomy and oversuturing of the lesion were performed to no avail. The patient has undergone over 10 endoscopies, and has received over 70 units of packed red cells to date, since his initial presentation 6\u2005years ago. Attempts to stop the bleeding permanently have been difficult, highlighting the complexity of managing such a lesion.<\/jats:p>","DOI":"10.1136\/bcr-2014-204627","type":"journal-article","created":{"date-parts":[[2014,9,12]],"date-time":"2014-09-12T18:42:40Z","timestamp":1410547360000},"page":"bcr2014204627","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Extragastric Dieulafoy's lesion"],"prefix":"10.1136","volume":"2014","author":[{"given":"James","family":"Gauci","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Galea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Galea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Schembri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,9,12]]},"reference":[{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.1","first-page":"85","article-title":"Diagnosis and management of upper gastrointestinal bleeding","volume":"105","author":"Biecker","year":"2008","journal-title":"Dtsch Arztebl Int"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.06.007"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(02)01801-X"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.4","first-page":"49","article-title":"Exulceratio simplex. L'intervention chirurgicale dans les hematemeses foudroyantes consecutive a l'exulceration simple des l'estomac","volume":"49","author":"Dieulafoy","year":"1898","journal-title":"Bull Acad Med"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.5","doi-asserted-by":"publisher","DOI":"10.1308\/003588410X12699663905311"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2008.09.033"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.7","first-page":"839","article-title":"Diagnostic evaluation and management of obscure gastrointestinal bleeding: a changing paradigm","volume":"5","author":"Pasha","year":"2009","journal-title":"Gastroenterol Hepatol (N Y)"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.8","first-page":"1689","article-title":"Dieulafoy lesions; a review of 6 years\u2019 experience of a tertiary referral centre","volume":"96","author":"Scmulewitz","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.07.027"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.10","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2003.328"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.11","first-page":"222","article-title":"Dieulafoy's lesion: an obscure cause of GI bleeding","volume":"44","author":"Al-Mishlab","year":"1999","journal-title":"J R Coll Surg Edinb"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.12","doi-asserted-by":"publisher","DOI":"10.1097\/LBR.0b013e3181606114"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.13","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2000.108040"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.14","first-page":"151","article-title":"Angiographic findings and endovascular embolization in Dieulafoy disease: a case report and literature review","volume":"12","author":"Alshumrani","year":"2006","journal-title":"Diagn Interv Radiol"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(04)00161-0"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.16","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2006.0063"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.17","doi-asserted-by":"publisher","DOI":"10.1136\/gut.34.6.857"},{"key":"2025042706291161000_2014.sep12_1.bcr2014204627.18","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.1999.01472.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-204627","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T13:29:18Z","timestamp":1745760558000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-204627"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,12]]},"references-count":18,"alternative-id":["10.1136\/bcr-2014-204627"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-204627","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2014,9,12]]}}}