Abstract

Torchio Ludovica*, Chiadò Piat Francesca, Varalda Alessia, Angera Simone, Giudici Gabriele and Baù Maria Grazia

We present a case of massive hematemesis due to a bleeding gastric Dieulafoy’s Lesion (DL) in a 30 weeks’ pregnant patient. DL is in an abnormally large diameter artery which runs within the submucosal layer of the gastrointestinal or respiratory tracts; DL can rupture causing a potentially life-threatening hemorrhage. To date, only three cases of bleeding DL in pregnant patients have been reported in the literature. Although DL is not frequently encountered in young women, pregnancy can be a predisposing factor. DL diagnosis is often insidious in our case since the extensive bleeding could not allow proper visualization, two esophagogastroduodenoscopies and one angiography were necessary to eventually detect the lesion. Combined endoscopic therapy with local epinephrine injection and endoclip placement was needed to stop the hemorrhage allowing successful treatment of our patient. The patient was able, one year and three months later, to carry a subsequent pregnancy to term and deliver a healthy child without any gastroenterological event.