Unmasking the Silent Bleeder: A Case of Dieulafoy’s Lesion

Dieulafoy’s lesion (DL), while infrequent, can lead to serious gastrointestinal bleeding, most often arising in stomach and sometimes exhibiting massive, recurrent hemorrhage. This report details middle-aged male, 45-year-old having chronic alcohol use and poorly controlled seizure disorder, who presented with hematemesis for 2 days and melena for 1 day. On admission, he was pale and tachycardic with anemia, thrombocytopenia, hyponatremia, hypoalbuminemia, and mild hyperbilirubinemia. Endoscopy revealed an actively bleeding DL in gastric body and managed with band ligation. Despite initial control, the patient developed further bleeding. Computed tomography angiography suggested an abnormal arterial feeder, which was confirmed on digital subtraction angiography as arising from the left gastric artery. Embolization with polyvinyl alcohol particles successfully achieved hemostasis and the patient stabilized with supportive care, including transfusion. This report emphasizes the early detection of DL and supports angiographic embolization as a valuable option when endoscopic management is inadequate.