Gastroenterology and hepatology: Dieulafoy lesion: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology and hepatology: Dieulafoy lesion

Sample item

A 60-year-old man has massive painless haematemesis. Endoscopy shows a pinpoint mucosal defect high on the lesser curve with a spurting vessel, and no ulcer crater or surrounding inflammation. What is the lesion?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Dieulafoy lesion

A Dieulafoy lesion is a large submucosal artery that protrudes through a tiny mucosal defect, usually in the proximal stomach, and causes recurrent massive bleeding. Endoscopic clips or banding are the treatment, and the lesion is easily missed.

Option by option

  • A. Dieulafoy lesion (correct)

    Correct. A spurting vessel through a tiny defect without an ulcer is a Dieulafoy lesion.

  • B. Gastric antral vascular ectasia

    Gastric antral vascular ectasia shows red stripes in the antrum with chronic bleeding.

  • C. Cameron lesion

    A Cameron lesion is an erosion at the neck of a hiatus hernia.

  • D. Mallory-Weiss tear

    A Mallory-Weiss tear follows retching and lies at the gastro-oesophageal junction.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Dieulafoy lesion. A Dieulafoy lesion is a large submucosal artery that protrudes through a tiny mucosal defect, usually in the proximal stomach, and causes recurrent massive bleeding.

Why is "Gastric antral vascular ectasia" not the answer?

Gastric antral vascular ectasia shows red stripes in the antrum with chronic bleeding.

Why is "Cameron lesion" not the answer?

A Cameron lesion is an erosion at the neck of a hiatus hernia.

Why is "Mallory-Weiss tear" not the answer?

A Mallory-Weiss tear follows retching and lies at the gastro-oesophageal junction.

What concept does this question test?

It tests Gastroenterology and hepatology: Dieulafoy lesion in General Medicine. Endoscopic clips or banding are the treatment, and the lesion is easily missed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology and hepatology: Dieulafoy lesion?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.