DIEULAFOY'S LESION: CLINICAL AND EPIDEMIOLOGICAL ANALYSIS OF AN UNCOMMON CAUSE OF GASTROINTESTINAL HEMORRHAGE

Dieulafoy’s lesions are a rare cause of gastrointestinal hemorrhage. Extragastric Dieulafoy’s lesions are even more uncommon. We report the case of a 75-year-old woman who presented with gastrointestinal bleeding from a transverse colonic Dieulafoy’s lesion. She presented with two episodes of melena followed by one episode of fresh blood per rectum. In addition, there was associated presyncope and anemia (hemoglobin 69 g/L) in the setting of supratherapeutic warfarin anticoagulation (INR 6.2) for nonvalvular atrial fibrillation. Esophagogastroduodenoscopy was negative for an upper GI source of bleeding but on colonoscopy an actively oozing Dieulafoy’s lesion was identified in the transverse colon. Bipolar cautery and hemostatic endoclips were applied to achieve hemostasis. Clinicians should consider this rare entity as a potential cause of potentially life-threatening lower gastrointestinal bleeding and we review the endoscopic modalities effective for managing colonic Dieulafoy’s lesions.

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Dieulafoy's lesion associated with truncus arteriosus type IV: An unusual cause of upper gastrointestinal hemorrhage

Journal of Pediatric Surgery ◽

10.1016/s0022-3468(89)80427-0 ◽

1989 ◽

Vol 24 (5) ◽

pp. 502

Author(s):

Richard R. Ricketts

Keyword(s):

Gastrointestinal Hemorrhage ◽

Truncus Arteriosus ◽

Upper Gastrointestinal Hemorrhage ◽

Dieulafoy’S Lesion ◽

Type Iv ◽

Upper Gastrointestinal

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Rectal Dieulafoy’s Lesion: A Rare Etiology of Lower Gastrointestinal Hemorrhage

Case Reports in Gastroenterology ◽

10.1159/000497139 ◽

2019 ◽

Vol 13 (1) ◽

pp. 73-77 ◽

Cited By ~ 1

Author(s):

Eric Omar Then ◽

Rani Bijjam ◽

Andrew Ofosu ◽

Prashanth Rawla ◽

Andrea Culliford ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Gastrointestinal Bleeding ◽

Gastrointestinal Hemorrhage ◽

Lower Gastrointestinal Bleeding ◽

Rare Presentation ◽

Lower Gastrointestinal Hemorrhage ◽

Dieulafoy’S Lesion ◽

Life Threatening ◽

Submucosal Vessel ◽

Upper Gastrointestinal

A Dieulafoy’s lesion is defined as a dilated submucosal vessel that erodes the overlying epithelium without evidence of a primary ulcer or erosion. It is a rare cause of gastrointestinal bleeding that is difficult to identify and subsequently manage. Most commonly, they occur in the upper gastrointestinal tract, namely the stomach. A Dieulafoy’s lesion of the rectum, however, is an exceedingly rare presentation that can lead to life-threatening gastrointestinal bleeding. Our case consists of an 84-year-old man, who presented with lower gastrointestinal bleeding secondary to a Dieulafoy’s lesion of the rectum.

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