The true incidence of Dieulafoy's disease is not known. The defect is more likely a congenital primary abnormality of a single arterial vessel. The histologic characteristic is an unusually large arterial vessel running immediately under the muscularis mucosae which protrudes into the mucosal layer and open wide. The clinical presentation may occur at any age and the diagnosis should be suspected in patients with massive recurrent upper gastrointestinal bleeding with paucity of symptoms and negative endoscopy or exploratory laparotomy. Although endoscopy may be the treatment of choice in the future, at present surgical intervention with simple ligation or preferably local excision of the bleeding vessel is recommended.

Key words: Dieulafoy, haematemesis, ulceration.

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