Dieulafoy Gastric Lesion: An Unusual Cause of Pediatric Hematemesis

Dieulafoy lesion is a vascular anomaly predominantly found in the stomach, which represents a rare cause of gastrointestinal bleeding and life-threatening haemorrhages in pediatric age with few cases reported in the literature. We experienced a 7-year-old previously healthy boy with hematemesis endoscopically diagnosed and successfully treated for a Dieulafoy lesion in the stomach. This case report illustrates the initial diagnostic workup and the possible differential diagnosis in presence of an acute episode of hematemesis in children. It focuses on an uncommon cause of gastrointestinal bleeding that is probably underestimated because of missing diagnosis. Any unusual and acute case of upper gastrointestinal bleeding should raise the suspicion of Dieulafoy lesion also in children, especially in those who have a past medical history negative for peptic disease and varices due to portal hypertension: a promptly endoscopy can provide visual diagnostic criteria and ensure an adequate hemostasis that is generally the definitive treatment of the lesion.