Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Nov 28, 2026; 32(44): 121710
Published online Nov 28, 2026. doi: 10.3748/wjg.121710
Published online Nov 28, 2026. doi: 10.3748/wjg.121710
Phenylephrine-provoked endoscopy reveals an occult Dieulafoy’s lesion in a duodenal diverticulum: A case report and review of literature
Yu-Jie Shen, Feng-Ling Hu, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Jiao-Jiao Song, Endoscopy Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Xiao-Qin Liu, Department of Gastroenterology, Jingning People’s Hospital, Lishui 323500, Zhejiang Province, China
Author contributions: Shen YJ contributed to drafting of manuscript; Song JJ and Liu XQ contributed to the literature review; Hu FL performed the endoscopic procedure and revised the manuscript; all authors approved the final version.
AI contribution statement: AI tools (DeepSeek, Doubao and Bimuyu) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors. The authors take full responsibility for all content presented in this article.
Supported by Zhejiang Provincial Natural Science Foundation of China, No. LQ22H030015.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Feng-Ling Hu, Chief Physician, Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310006, Zhejiang Province, China. 1509035@zju.edu.cn
Received: March 31, 2026
Revised: May 13, 2026
Accepted: June 11, 2026
Published online: November 28, 2026
Processing time: 183 Days and 15.3 Hours
Revised: May 13, 2026
Accepted: June 11, 2026
Published online: November 28, 2026
Processing time: 183 Days and 15.3 Hours
Core Tip
Core Tip: Dieulafoy’s lesion inside a duodenal diverticulum is difficult to identify during quiescent phase. Conventional provocative protocols use antithrombotic agents, accompanied by delayed and unpredictable bleeding onset. This case confirms that phenylephrine provocation combined with colonoscopy enables accurate localization of occult Dieulafoy’s lesion in the distal duodenal diverticulum.