S4650 Active Gastrointestinal Bleeding From Dieulafoy Lesion on Abdominal Computed Tomography Angiography Imaging

Introduction: Dieulafoy lesions are a rare but significant cause of upper gastrointestinal (GI) bleeding, accounting for approximately 6% of cases. These lesions are often challenging to diagnose, especially when the initial esophagogastroduodenoscopy (EGD) is non-diagnostic. Case Description/Methods: We present the case of a 77-year-old woman with a history of cardiovascular and gastrointestinal diseases who presented with acute blood loss anemia and hypotension. Initial EGD was non-diagnostic, but a subsequent computerized tomography with angiography (CTA) revealed an active bleed from a Dieulafoy lesion. This finding guided a successful repeat endoscopy with hemostatic clipping, leading to stabilization of the patient. Discussion: This case highlights the importance of computed tomography angiography in conjunction with EGD for diagnosing and managing elusive Dieulafoy lesions, particularly in high-risk patients. The multimodal approach outlined in this case adds to existing literature by demonstrating how imaging can complement standard endoscopic management, ultimately improving diagnostic accuracy and patient outcomes.