Table 2.

Diagnosis of Dieulafoy’s lesion

EGD

Small, relatively inconspicuous pigmented protuberance with minimal surrounding erosion and no ulceration

Lesion often actively bleeding or oozing at EGD

Gastric lesions most commonly within 6 cm of GE junction along lesser curve

Initial EGD may be nondiagnostic in up to 30% of cases due to relatively small lesion size

Avoid endoscopic biopsies of lesion

Colonoscopy or enteroscopy

May be useful to diagnose colonic or jejunoileal lesions, respectively, if EGD was negative in setting of severe, acute GI bleeding

Angiography

May be helpful in setting of rectal bleeding after negative EGD and colonoscopy

EGD: Esophagogastroduodenoscopy; GI: Gastrointestinal.