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Abstract L’ulcère de Dieulafoy est une cause rare d’hémorragie digestive massive pouvantêtre fatale. Le saignement se produit à partir d’une anomalie vasculaire définiepar la présence dans la sous- muqueuse, d’une artère aberrante anormalementlarge. La localisation gastrique est la plus fréquemment rapportée mais de rarescas ont été confirmés à l’examen anatomopathologique.Nous rapportons l’observation d’un homme de 32 ans opéré en urgence pour unehémorragie digestive haute massive, menaçant le pronostic vital et ne permettantpas de localiser la lésion à l’examen endoscopique. Un ulcère de Dieulafoygastrique a été diagnostiqué en per opératoire, traité par wedge résection etconfirmé à l’examen histopathologique. Abstract Dieulafoy’s lesion is a rare cause of massive digestive hemorrhage that can be fatal. Bleeding occurs from a vascular abnormality defined by the presence in the submucosa of an abnormally large aberrant artery. Gastric localization is the most frequently reported, but rare cases have been confirmed by histology.We report the case of a 32-year-old man operated on an emergency for massive upper gastrointestinal haemorrhage, which is life threatening and not allowing to locate the lesion with the endoscopic examination. A Dieulafoy’s gastric lesion was diagnosed intraoperatively, treated by wide wedge resection and confirmed by histology.

Abstract Background Dieulafoy’s disease of the bronchus can cause massive and even fatal hemoptysis. Even though it is rare, it should be considered by physicians all over the world. This paper reports a case of bronchial Dieulafoy’s disease and summarizes the data of similar cases reported in literature. Methods We report a case of bronchial Dieulafoy’s disease (BDD) in Tunisia. We also present a review of literature related to BDD from 1995 to 2022 using the PubMed, Google Scholar, web of science and Chinese National Knowledge Infrastructure Databases. Clinical characteristics, chest imaging, bronchoscopic and angiographic findings were summarized. Treatment courses were identified as well as patients’ outcome. Results We report the case of a 41-year-old man, so far in good health, presenting with massive hemoptysis. Bronchoscopy showed blood clots and a protruding lesion covered by mucosa with a white pointed cap at the entrance of the right upper lobe. Biopsies were not attempted. Embolization of bronchial artery was first realized and was not successful, with post procedure complications. Surgical intervention stopped the bleeding and pathological examination of the resected specimen confirmed Dieulafoy’s disease of the bronchus. Ninety cases of BDD were reported from 1995 to 2022. The main symptom was hemoptysis. Chest imaging findings were not specific. The diagnosis of BDD was mainly based on the bronchoscopy, branchial angiography and pathological findings or surgical specimens. Bronchoscopy findings were mostly nodular or prominent lesions (52.4%). Twenty-eight patients underwent bronchoscopic biopsies, 20 had massive bleeding and 10 died. Bronchial angiography mainly showed tortuous and dilation of bronchial artery, and the lesions were mainly located in the right bronchus. Selective bronchial artery embolization (SBAE) was performed in 32 patients and 39 patients underwent surgery. Conclusion To our knowledge, this is the first case of bronchial Dieulafoy’s disease to be reported in Tunisia and North Africa. When the diagnosis is suspected, bronchoscopic biopsy should be avoided as it might lead to fatal hemorrhage. Selective bronchial artery embolization can stop the bleeding, but surgery can be required.

Background: Dieulafoy's disease of the bronchus can cause massive and even fatal hemoptysis. Even though it is rare, it should be considered by physicians all over the world. This paper reports a case of bronchial Dieulafoy's disease and summarizes the data of similar cases reported in literature. Methods: We report a case of bronchial Dieulafoy's disease (BDD) in Tunisia. We also present a review of literature related to BDD from 1995 to 2022 using the PubMed, Google Scholar, web of science and Chinese National Knowledge Infrastructure Databases. Clinical characteristics, chest imaging, bronchoscopic and angiographic findings were summarized. Treatment courses were identified as well as patients' outcome. Results: We report the case of a 41-year-old man, so far in good health, presenting with massive hemoptysis. Bronchoscopy showed blood clots and a protruding lesion covered by mucosa with a white pointed cap at the entrance of the right upper lobe. Biopsies were not attempted. Embolization of bronchial artery was first realized and was not successful, with post procedure complications. Surgical intervention stopped the bleeding and pathological examination of the resected specimen confirmed Dieulafoy's disease of the bronchus. Ninety cases of BDD were reported from 1995 to 2022. The main symptom was hemoptysis. Chest imaging findings were not specific. The diagnosis of BDD was mainly based on the bronchoscopy, branchial angiography and pathological findings or surgical specimens. Bronchoscopy findings were mostly nodular or prominent lesions (52.4%). Twenty-eight patients underwent bronchoscopic biopsies, 20 had massive bleeding and 10 died. Bronchial angiography mainly showed tortuous and dilation of bronchial artery, and the lesions were mainly located in the right bronchus. Selective bronchial artery embolization (SBAE) was performed in 32 patients and 39 patients underwent surgery. Conclusion: To our knowledge, this is the first case of bronchial Dieulafoy's disease to be reported in Tunisia and North Africa. When the diagnosis is suspected, bronchoscopic biopsy should be avoided as it might lead to fatal hemorrhage. Selective bronchial artery embolization can stop the bleeding, but surgery can be required. [ABSTRACT FROM AUTHOR]

Dieulafoy's disease is a rare and important cause of recurrent upper gastrointestinal bleeding, which can cause fatal gastrointestinal bleeding. We reported a patient with Dieulafoy's disease in both of the stomach and duodenum for the first time. The patient achieved no effective hemostasis after two endoscopic treatments and two arterial angiography embolizations. Finally, successful hemostasis was achieved through surgery. There are many endoscopic treatment methods, but there is no consensus on the best treatment for hemorrhagic Dieulafoy's disease. Surgery is only a last resort after the failure of endoscopic treatment and angiography embolization. [ABSTRACT FROM AUTHOR]

Dieulafoy’s lesion is a rare cause of massive digestive hemorrhage that can be fatal. Bleeding occurs from a vascular abnormality defined by the presence in the submucosa of an abnormally large aberrant artery. Gastric localization is the most frequently reported, but rare cases have been confirmed by histology.We report the case of a 32-year-old man operated on an emergency for massive upper gastrointestinal haemorrhage, which is life threatening and not allowing to locate the lesion with the endoscopic examination. A Dieulafoy’s gastric lesion was diagnosed intraoperatively, treated by wide wedge resection and confirmed by histology.

We report a case of bronchial Dieulafoy's disease in the pediatric age. Angio-computed tomography scan and arteriography addressed us to diagnosis. Bronchial endoscopy with biopsy was avoided due to the high risk of developing a life-threatening hemorrhage. Transcatheter embolization of the bleeding bronchial artery was achieved with a MicroPlex® 10 HyperSoft 3D 3.5 mm × 80 mm System (MicroVention, Tustin, CA, USA). Dieulafoy's disease is an extremely rare lesion in the pediatric age, and the small diameter of the bleeding vessels may complicate the percutaneous approach with procedural failure. Currently, the novel thin and soft detachable coils allowed to widen the transcatheter embolization in the pediatric age.

We report a case of bronchial Dieulafoy's disease in the pediatric age. Angio-computed tomography scan and arteriography addressed us to diagnosis. Bronchial endoscopy with biopsy was avoided due to the high risk of developing a life-threatening hemorrhage. Transcatheter embolization of the bleeding bronchial artery was achieved with a MicroPlex® 10 HyperSoft 3D 3.5 mm × 80 mm System (MicroVention, Tustin, CA, USA). Dieulafoy's disease is an extremely rare lesion in the pediatric age, and the small diameter of the bleeding vessels may complicate the percutaneous approach with procedural failure. Currently, the novel thin and soft detachable coils allowed to widen the transcatheter embolization in the pediatric age. [ABSTRACT FROM AUTHOR]

Abstract Background Dieulafoy's disease of the bronchus is an arterial abnormality characterized by enlarged mucosal arterial branches that are susceptible to lethal bleeding. To date, this disease is rarely reported in the literature. We recently encountered three patients from February 2010 to March 2017, each with such a vascular anomaly in a bronchus with massive hemoptysis. Aim This paper describes the clinical characteristics and treatments for Dieulafoy's disease. Methods We report three cases with recurrent massive hemoptysis. Bronchoscopic examination was performed on two patients, one with a non-pulsating polypoid nodule and the other without. One patient had fatal bleeding after biopsy and could not withstand bronchial artery embolization or thoracotomy. Angiography and bronchial artery embolization on another two patients successfully stopped the bleeding. In addition, we retrospectively reviewed the literature on all reported cases with cryptogenic hemoptysis, obtained through PubMed and Chinese journal searches. Results The intervention with embolization was successful, and no new episodes of acute hemoptysis were observed. Conclusion Angiography can be used for diagnosis of Dieulafoy's disease of the bronchus, whereas bronchoscopy biopsy should be avoided. Interventions such as embolization or bronchial coagulation play an important role in patients with coughing with massive hemoptysis. [ABSTRACT FROM AUTHOR]

Dieulafoy's disease is an uncommon condition, the usual site of occurrence being the gastrointestinal tract. The condition refers to the presence of a dysplastic submucosal artery with mucosal vascular branches that has propensity to cause recurrent bleeding. Dieulafoy's disease of the bronchus is rare. Herein, we describe the case of a 26-year-old male who presented with recurrent bouts of hemoptysis and bronchial Dieulafoy's disease was diagnosed. Flexible bronchoscopy was performed, and argon plasma coagulation (APC) of the bleeding lesion was done. The procedure was successful and was followed by complete eradication of the vascular malformation and cessation of hemoptysis. APC is a useful tool in the armamentarium of an interventional pulmonologist that can allow rapid and safe control of bleeding from superficially located and bleeding endobronchial lesions, and can be easily and effectively applied using a flexible bronchoscope.

Although there are many clinical reports on Dieulafoy's disease, there are few studies on the pathological structure of vascular wall in Dieulafoy's disease. In this study, the main structural changes of the intima and media of the vascular wall were observed by special staining and immunohistochemical methods in the subjects of Dieulafoy's disease of stomach and intestine. There were many vessels of different sizes in the submucosa, with uneven wall thickness of the vessels. Compared with the normal control group, the content of blue collagen fibers between the vascular smooth muscle cells in the lesion group was increased, the elastic fibers were thickened, and the internal elastic plate was arranged stiff or even interrupted. The increase of collagen and elastic fibers between the smooth muscle cells of the medium membrane and the destruction of the structure of the inner elastic plate may be the structural basis of vascular lesions leading to Dieulafoy's disease. [ABSTRACT FROM AUTHOR]

Dieulafoy's disease of the bronchus is a relatively rare cause of hemoptysis. It can be completely asymptomatic and diagnosed as an incidental finding on bronchoscopy. At the other end of the spectrum, it can present with potentially fatal hemorrhage. We present a case of a 13-year old boy who suffered from massive hemoptysis. Endobronchial ultrasound (EBUS) and bronchial artery embolization (BAE) proved useful in the initial management. This case may support the role of EBUS in the diagnosis of Dieulafoy's disease as well as other intrapulmonary vascular lesions.

Dieulafoy’s disease is a rare vascular malformation represented by an abnormally enlarged submucosal arterial vessel. This malformation is mostly found in gastrointestinal tract causing spontaneous bleeding although a few cases have been described in the bronchial tree. Recognizing Dieulafoy’s malformation is crucial for the bronchoscopist in order to avoid biopsy that can lead to a massive hemoptysis, sometimes fatal. In this case report we show the clinical utility of endobronchial ultrasound (EBUS) in the evaluation of bronchial alteration suspicious for Dieulafoy’s malformation.

Dieulafoy's disease of the lung is one of the causes of cryptogenic hemoptysis often massive and recurrent, caused by dysplastic superficially located arteries in the bronchial wall. Being a rare condition, available literature on this condition is limited to a few case reports and series. We report three such cases presenting with severe hemoptysis uncontrolled by bronchial artery embolization who subsequently underwent resection of the involved lobe of the lung. The clinical, radiological, bronchoscopic, and pathological features are discussed with emphasis on the gross and microscopic characteristics that aid in the pathological diagnosis in the resected specimens. [ABSTRACT FROM AUTHOR]

Dieulafoy's disease is an uncommon but potentially significant cause of gastrointestinal bleeding caused by a large-caliber arterial vessel in the submucosa, which causes erosion and debilitation of the surrounding mucosa and may lead to massive gastrointestinal bleeding. Since endoscopy may prove insufficient, echoendoscopy may help in the diagnosis of this condition. Echoendoscopy may also help improve endoscopic management using mechanical techniques (hemoclips or band ligation) or a combination of thermal techniques and injection sclerotherapy, since this allows an accurate localization of the submucosal vessel. We present a case illustrating this approach by endoscopic ultrasonography, and describe the morphological substrate of this condition.La enfermedad de Dieulafoy constituye una causa rara pero potencialmente muy grave de hemorragia digestiva. Se debe a la presencia de un vaso arterial de gran calibre en la submucosa, en contacto con una mucosa a la que debilita y erosiona, lo que puede conducir a un sangrado digestivo de gran magnitud. El diagnóstico endoscópico no siempre es fácil, siendo la ecoendoscopia una técnica que puede venir a solucionar estas dificultades. Además, dado que permite localizar con gran exactitud este vaso submucoso, puede contribuir a aumentar la precisión del tratamiento endoscópico mediante métodos mecánicos (hemoclips o bandas elásticas) o la combinación de métodos térmicos y la inyección de sustancias esclerosantes. Presentamos a continuación un caso que ilustra perfectamente esta aplicación de la ultrasonografía endoscópica, definiendo perfectamente el sustrato morfológico de esta entidad.

Dieulafoy's disease is defined as a vascular anomaly characterized by the presence of a tortuous dysplastic artery in the submucosa, from which vascular branches, that can be located in the mucosa, derive. A 36 years old woman was admitted to the hospital with relapsing haemoptysis. After a first urgent bronchoscopy, a new bronchoscopy showed in the upper left bronchus in the ventral branch (B3) the presence of a small protrusion of rich vascularized mucosa with preserved peripheral canalization. The patient was submitted to an arteriography, performing a vascular deafferentation of the peripheral branches, and of the middle third of the afferent supplying branch. [ABSTRACT FROM AUTHOR]

Dieulafoy's disease of the bronchus is a relatively rare cause of hemoptysis. It can be completely asymptomatic and diagnosed as an incidental finding on bronchoscopy. At the other end of the spectrum, it can present with potentially fatal hemorrhage. We present a case of a 13-year old boy who suffered from massive hemoptysis. Endobronchial ultrasound (EBUS) and bronchial artery embolization (BAE) proved useful in the initial management. This case may support the role of EBUS in the diagnosis of Dieulafoy's disease as well as other intrapulmonary vascular lesions. [ABSTRACT FROM AUTHOR]

Dieulafoy's disease is an uncommon condition, the usual site of occurrence being the gastrointestinal tract. The condition refers to the presence of a dysplastic submucosal artery with mucosal vascular branches that has propensity to cause recurrent bleeding. Dieulafoy's disease of the bronchus is rare. Herein, we describe the case of a 26-year-old male who presented with recurrent bouts of hemoptysis and bronchial Dieulafoy's disease was diagnosed. Flexible bronchoscopy was performed, and argon plasma coagulation (APC) of the bleeding lesion was done. The procedure was successful and was followed by complete eradication of the vascular malformation and cessation of hemoptysis. APC is a useful tool in the armamentarium of an interventional pulmonologist that can allow rapid and safe control of bleeding from superficially located and bleeding endobronchial lesions, and can be easily and effectively applied using a flexible bronchoscope. [ABSTRACT FROM AUTHOR]

Dieulafoy’s disease of the lung is very rare. We present 2 cases, which are, to our knowledge, the 9th and 10th cases reported in the literature. Haemoptysis is the leading symptom of Dieulafoy’s lesion of the lung. In spite of its rareness, the lesion is relevant to the bronchoscopist because a biopsy of the unobtrusive but characteristic bronchial manifestation can precipitate profuse arterial bleeding with a fatal outcome. The bleeding can occur immediately after the biopsy and/or after an interval of up to 12 days. Angiographic images document that this vascular malformation is based on a left-to-right shunt, with a bronchial artery draining into a pulmonary artery. Endobronchial ultrasound may be helpful in detecting the vascular nature of the lesion. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Dieulafoy's disease is characterized by abnormal submucosal arteries and results in acute luminal hemorrhage. Dieulafoy's lesions can also be found in the submucosa of the bronchus. Due to its low incidence rate and non-specific clinical symptoms, Dieulafoy's disease is easy to overlook, but can lead to massive bleeding and high rates of mortality. Therefore, improvements in the understanding of the disease are necessary. The awareness of the disease and associated diagnostic and treatment techniques have continued to improve, and thus, an increasing number of cases of Dieulafoy's disease of the bronchus have been reported. In the present review, 74 cases of Dieulafoy's disease are summarized. New technologies such as endobronchial ultrasound, narrow-band imaging, angiography and argon plasma treatment have been found to be increasingly applied to diagnose and treat Dieulafoy's disease of the bronchus. Therefore, the primary focus of this systematic review is to highlight advances in the diagnosis and treatment of bronchial Dieulafoy's disease. [ABSTRACT FROM AUTHOR]

Abstract We present a case of a 57 year old woman who suffered from massive hemoptysis; she was sent to our Department for a suspect neoformant lesion. We assumed it might be a Dielafoy’s disease and proceeded with an imaging study that confirmed the diagnosis. After embolization the patient no longer showed signs of bleeding. In brief, we concluded that whenever there is a suspect of Dielafoy’s disease, the biopsy has to be avoided.

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The case of a 60-year-old man with massive lower intestinal bleeding, secondary to erosion of an abnormally large submucosal muscular artery in the ascending colon, is reported The bleeding site was localized by angiography. The clinicopathologic presentation of this case is identical to Dieulafoy's disease, which occurs almost exclusively in the stomach. Three similar patients with lesions also located in the ascending colon have been reported in the English medical literature. [ABSTRACT FROM AUTHOR]

Background: At present, minimally invasive endoscopic treatment is mostly used for patients with actively bleeding Dieulafoy's lesions, , as it has the advantages of minimal trauma, short operation time and good hemostatic effect, although bleeding can easily recur postoperatively. Recently, extensive gastric cuneiform resection has been advocated for use in these patients because the constant-diameter artery follows a long path to the gastric mucosa., Case Summary: A 47-year-old man was admitted to the hospital for repeated hematemesis and black stool, and he was diagnosed with Dieulafoy's disease. We chose a method that not only simulates surgical gastric cuneiform resection but also reduces trauma. We performed enlarged local endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery and sutured the gastric wall. Postoperative follow-up showed that the constant-diameter artery had been resected from the gastric wall, which was confirmed to have no blood flow signals by endoscopic ultrasonography., Conclusion: Endoscopic full-thickness resection of the gastric wall and abdominal constant-diameter artery with suturing of the gastric wall has demonstrated potential as a new treatment for Dieulafoy's disease., Competing Interests: Conflict-of-interest statement: The authors declared that they have no conflicts of interest regarding this work., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

We present the case of a 30-year-old non-smoker who presented with unexplained, massive hemoptysis and was diagnosed with a rare vascular malformation. [ABSTRACT FROM AUTHOR]

A 4-month-old female was seen following massive hematemesis caused by an isolated gastric Dieulafoy's lesion. The case is presented and the literature reviewed. [ABSTRACT FROM AUTHOR]

Massive cryptogenic hemoptysis is a common presenting symptom and cause of hospitalization for respiratory diseases, and represents a challenging condition in the clinical. This study aimed to analyze the clinical and pathologic data and management of patients with massive cryptogenic hemoptysis. We retrospectively reviewed 12 patients with massive cryptogenic hemotysis in our hospital between January 2003 and December 2012. Bronchoscopy showed submucosal vascular abnormalities in 4 patients. Of 6 patients managed with conservative measures, bleeding was completely controlled in 2 patients. Of 10 hemoptysis patients, three were controlled by bronchial arterial embolization, and seven by surgery. Pathological examination showed a superficial dysplastic, tortuous and dilated bronchial artery under the bronchial epithelium in 4 patients, and bronchiole dilation in 2 patients, indicating Dieulafoy's disease of the bronchus and bronchiectasis. No malignance developed within the follow-up. In conclusion, Dieulafoy's disease of the bronchus and bronchiectasis should be suspected in patients with massive cryptogenic hemoptysis. BAE and surgical treatment should be considered in case that massive hemoptysis could not be controlled by conservative management.

The hypervascularization of the bronquial wall, secondary to chronic bronchopulmonary inflammation is a bleeding etiology in smokers, but insufficient to explain certain massive recurrent cases. We report a case of a woman with a smoking history who presented a recurrent and massive hemoptysis. A diagnostic study with laboratory tests, bronchoscopy, computed tomography and echocardiogram did not identify the etiological cause. However, bronchial arteriography showed right and left bronchial tortuous and dilated arteries and demonstrated that a bronchovascular fistula was the origin of the hemoptysis. An acquired form of the Dieulafoy's disease in this context of a smoking history might justify such findings. Bronchial arteriography as a diagnostic method should be the preferred choice rather than bronchoscopy in these cases., (Copyright © 2015 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)