Hospitalization and diagnosis
Owing to the associated symptoms and unstable vital signs an emergent Transcatheter Arterial Embolization (TAE) was performed immediately. Subsequently, after angiographic confirmation of active bleeding from a branch of the superior mesenteric artery, superselective embolization was completed through gelfoam cubes injection. After admission to the general ward in stable condition we arranged for a painless double-balloon enteroscopy for the purpose of obtaining a differential diagnosis on the 5th day of hospitalization. This procedure revealed a 15-millimeter sized subepithelial tumor at the proximal jejunum, with ulceration centrally and hyperemia peripherally (Figure 3). We consulted surgeons regarding laparoscopic surgical resection being performed the following day under the impression of potential malignancy and a high risk of recurrent bleeding (Figure 4). The patient was then discharged on the 8th day of hospitalization. A pathologist then confirmed jejunal Dieulafoy's lesion with organizing thrombus, and no recurrent bleeding was noted thereafter.

Figure 3. Double-balloon enteroscopy

Figure 4. Laparoscopic surgical resection