{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T20:30:16Z","timestamp":1758054616863,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,8,20]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>Dieulafoy lesions are a rare, non-variceal cause of gastrointestinal (GI) bleeding arising from dilated submucosal arteries without any underlying ulcer, which if undiagnosed can cause significant morbidity and mortality. We present a young female with massive upper and lower GI bleeding with haemodynamic instability, the source of which could not be identified with upper and lower endoscopy or radiological investigations. We therefore employed capsule endoscopy, which identified the location as the mid-jejunum. In view of ongoing bleeding, an emergency laparotomy with resection and anastomosis of the affected bowel was performed. Massive obscure small bowel bleeds pose major diagnostic and therapeutic challenges, which can be tackled only by timely intervention.<\/jats:p>","DOI":"10.1136\/bcr-2025-266494","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T04:45:17Z","timestamp":1757911517000},"page":"e266494","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Jejunal Dieulafoy lesion causing massive gastrointestinal bleed"],"prefix":"10.1136","volume":"18","author":[{"given":"Vivek G","family":"Nath","sequence":"first","affiliation":[{"name":"Surgical Gastroenterology, Believers Church Medical College Hospital, Thiruvalla, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6543-7109","authenticated-orcid":false,"given":"Hari Govind","family":"K","sequence":"additional","affiliation":[{"name":"Surgical Gastroenterology, Believers Church Medical College Hospital, Thiruvalla, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak K","family":"Johnson","sequence":"additional","affiliation":[{"name":"Medical Gastroenterology, Believers Church Medical College Hospital, Thiruvalla, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Joseph","sequence":"additional","affiliation":[{"name":"Pathology, Believers Church Medical College Hospital, Thiruvalla, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujith","family":"Philip","sequence":"additional","affiliation":[{"name":"Surgical Gastroenterology, Believers Church Medical College Hospital, Thiruvalla, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahitha Raj","family":"Ajimol Rajeev","sequence":"additional","affiliation":[{"name":"Surgical Gastroenterology, Believers Church Medical College Hospital, Thiruvalla, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,14]]},"reference":[{"key":"2025091421451216000_18.9.e266494.1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2003.328"},{"key":"2025091421451216000_18.9.e266494.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2008.09.033"},{"key":"2025091421451216000_18.9.e266494.3","doi-asserted-by":"publisher","DOI":"10.1308\/003588410X12699663905311"},{"key":"2025091421451216000_18.9.e266494.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.03922.x"},{"key":"2025091421451216000_18.9.e266494.5","doi-asserted-by":"crossref","first-page":"3436","DOI":"10.1007\/s10620-010-1385-0","article-title":"Dieulafoy lesions of the GI tract: localization and therapeutic outcomes","volume":"55","author":"Lara","year":"2010","journal-title":"Dig Dis Sci"},{"key":"2025091421451216000_18.9.e266494.6","doi-asserted-by":"publisher","DOI":"10.1136\/gut.34.6.857"},{"key":"2025091421451216000_18.9.e266494.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(02)01801-X"},{"key":"2025091421451216000_18.9.e266494.8","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.5858\/2006-130-e27-AYMWEO","article-title":"A 70-Year-Old Man With Episodes of Upper Gastrointestinal Bleeding","volume":"130","author":"Pathan","year":"2006","journal-title":"Arch Pathol Lab Med"},{"key":"2025091421451216000_18.9.e266494.9","doi-asserted-by":"crossref","DOI":"10.1177\/2324709620987703","article-title":"Jejunal Dieulafoy\u2019s Lesion: A Systematic Review of Evaluation, Diagnosis, and Management","volume":"9","author":"Malik","year":"2021","journal-title":"J Investig Med High Impact Case Rep"},{"key":"2025091421451216000_18.9.e266494.10","doi-asserted-by":"crossref","first-page":"552","DOI":"10.5946\/ce.2023.231","article-title":"Jejunal Dieulafoy\u2019s lesion resembling subepithelial mass resulting in profound gastrointestinal hemorrhage","volume":"57","author":"Chaemsupaphan","year":"2024","journal-title":"Clin Endosc"},{"key":"2025091421451216000_18.9.e266494.11","article-title":"Dieulafoy\u2019s Lesion of the Duodenum: A Rare and Fatal Cause of Gastrointestinal Bleed","volume":"15","author":"Qasim","year":"2023","journal-title":"Cureus"},{"key":"2025091421451216000_18.9.e266494.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.07.027"},{"key":"2025091421451216000_18.9.e266494.13","doi-asserted-by":"crossref","unstructured":"Fortinsky KJ , Barkun AN . 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