Dieulafoy lesions (DLs) are a rare cause of upper gastrointestinal bleeding (UGIB), accounting for about 1% of cases, and are more frequent in adult males. They can lead to hemodynamic instability and hypovolemic shock. Initial management is typically endoscopic, tailored to the patient's clinical condition; however, surgical intervention is indicated in cases of persistent or severe instability. Hemodynamic support is essential to improve survival. Initial resuscitation in hypovolemic shock remains challenging, as fluid replacement must be guided by specific hemodynamic goals. Management includes not only crystalloids but also transfusion of blood products, such as packed red blood cells, fresh frozen plasma, and platelets, to maintain adequate perfusion and tissue oxygenation. We report the case of a female patient with UGIB secondary to a Dieulafoy lesion, successfully managed with targeted fluid resuscitation, blood products, vasopressors, and definitive surgical intervention, leading to resolution of bleeding and stabilization of her clinical condition.
Medrano et al. (Wed,) studied this question.