Rectal Dieulafoy Research Articles

Rectal Dieulafoy Lesion Managed by Hemostatic Clips

The classic Dieulafoy lesion is a minute gastric mucosal defect which bleeds massively from an exposed artery. The typical endoscopic appearance of this lesion is a single, round mucosal defect with an artery protruding from its base in the absence of surrounding ulceration. We encountered an 89-year-old man who developed sudden massive fresh rectal bleeding. The source of hemorrhage was found at colonoscopy after careful irrigation and inspection to be a Dieulafoy lesion situated in rectum. Hemostasis was achieved successfully with epinephrine injection and endoscopic hemostatic clipping.

A case of rectal Dieulafoy’s lesion successfully treated by transcatheter arterial embolization

A 50-year-old man showed massive lower gastrointestinal bleeding without a triggering episode. An emergency colonoscopy revealed a protruding vessel in the lower rectum with no active bleeding. No underlying ulcer was seen within the surrounding mucosa. These findings were consistent with rectal Dieulafoy's lesion. Angiography was requested to identify the source of bleeding and for possible embolization. On the initial angiography, the bleeding point was unclear. Abnormal vessels such as arteriovenous malformation or nidus were not found. He again developed hematochezia, requiring transfusion of red blood cells. However, the second colonoscopy showed no active bleeding from the protruding vessel in the rectum. During the second angiography, sudden bleeding occurred. Angiography showed extravasation of contrast medium from the distal branch of the superior rectal artery. Transcatheter arterial embolization was performed, and was very effective.

Rectal Dieulafoy Lesion Following Manual Disimpaction Successfully Treated with Hemoclip

Purpose: Rectal Dieulafoy lesions are a rare cause of lower gastrointestinal bleed with few case reports describing the etiology and treatment of these lesions. A majority of Dieulafoy lesions are found in the stomach, but other locations including small intestine, colon, and rectum have been reported with increasing frequency. We report a case of a rectal Dieulafoy lesion secondary to trauma from recurrent disimpaction treated successfully with hemoclip. Results: A 54-year-old female with history of multiple sclerosis presented with bright red blood per rectum associated with a near syncopal event. She denied using non-steroidal anti-inflammatory medications, prior ulcer disease, or history of GI bleeding. As stated, she had a history of multiple sclerosis and required periodic self disimpaction. Upon presentation, she was noted to be hypotensive and tachycardic. Following aggressive resuscitation, her blood pressure improved, but she remained tachycardic. Her initial hemoglobin was 11.7 g/dL. During her evaluation in the emergency department, she continued to have bright red blood per rectum and a drop in hemoglobin to 10.1 g/dL. Flexible sigmoidoscopy was performed with visualization of a pulsating Dieulafoy lesion in the rectum approximately 4 cm from the dentate line. The Dieulafoy lesion was treated successfully with one hemoclip without further bleeding. She was monitored closely and placed on aggressive bowel protocol to alleviate the need for disimpaction. Her blood counts remained stable and there were no further episodes of bleeding. Upon follow up a couple months later, she was doing well with no further need for self disimpaction or recurrent bleeding.Figure: Rectal Dieulafoy lesion.Figure: Rectal Dieulafoy lesion following hemoclip placement.

Massive Bleeding From a Rectal Dieulafoy Lesion: Combined Multidetector-row CT Diagnosis and Endoscopic Therapy

Dieulafoy lesion is an uncommon cause of acute gastrointestinal bleeding. The diagnosis is usually carried out endoscopically. We report a 77-year-old woman with rectal Dieulafoy lesion. A recent endoscopic examination missed the lesion because it was small and the bleeding was intermittent. In our case, prompt colonoscopic therapy was allowed after locating the bleeder by multidetector-row computed tomography. On the basis of the success of this procedure, we suggest that an emergent multidetector-row computed tomography could have a role in the management of patients with massive lower gastrointestinal bleeding.

Massive low gastrointestinal bleeding due to a Dieulafoy rectal lesion

Massive low gastrointestinal bleedings are often difficult diagnostically and in terms of management. Sometimes, it is not possible to identify the bleeding point after performing diverse diagnostic tests and the patient undergoes a blind subtotal colectomy. With rectal bleeding, this form of surgery is completely useless, as it will not solve the cause of the haemorrhage. The Dieulafoy lesion has been widely described in the stomach, but in the rectum is a very rare entity that can cause massive lower gastrointestinal bleeding. In the literature, there are only 25 described cases of rectal Dieulafoy lesion.

Endoscopic band ligation for the treatment of rectal Dieulafoy lesions: risks and disadvantages

Endoscopic band ligation for the treatment of rectal Dieulafoy lesions: risks and disadvantages

Rectal Dieulafoy Lesions

Rectal Dieulafoy Lesions

Two cases of rectal Dieulafoy’s ulcer

Two cases of rectal Dieulafoy’s ulcer

Successful endoscopic clipping of rectal dieulafoy's lesion: Case report

Successful endoscopic clipping of rectal dieulafoy's lesion: Case report

A Case of Rectal Dieulafoy’s Ulcer and Successful Endoscopic Band Ligation

Dieulafoy's ulcer is a rare cause of gastrointestinal bleeding. The lesion is usually located in the stomach, although it may occur anywhere in the gastrointestinal tract. A 44-year-old man was admitted to hospital due to cerebral infarction. On the 23rd day of hospitalization, he showed massive hematochezia. He underwent an urgent colonoscopy. There was a visible protuberant vessel without significant ulceration at the fundus of the rectum, consistent with a Dieulafoy's ulcer. It was treated by endoscopic hemoclipping. However, rebleeding occurred three times despite repeated hemoclipping. Finally, endoscopic band ligation was successfully performed to achieve permanent hemostasis. Endoscopic band ligation is an effective treatment for bleeding rectal Dieulafoy's ulcer.

Rectal Dieulafoy's lesion

An 81-year-old man with a history of chronic renal failure and hypertension was hospitalized because of pneumonia. Endotracheal intubation was required on the 5th hospital day because of respiratory distress. Massive rectal bleeding developed abruptly on hospital day 15. The blood pressure declined to 60/47 mm Hg and the Hb level decreased from 10.2 g/dL to 7.3 g/dL. Six units of packed red blood cells were transfused. Urgent colonoscopy failed to identify a definite source of hemorrhage because of copious amounts of fresh and clotted blood in the rectum and in the sigmoid colon.

Rectal Dieulafoy’s lesion presenting as massive lower GI bleeding

Rectal Dieulafoy’s lesion presenting as massive lower GI bleeding

A case report of rectal Dieulafoy’s ulcer

A case report of rectal Dieulafoy’s ulcer

Treatment of rectal hemorrhage by coil embolization

Four patients, aged 54-84 years, presenting with life-threatening rectal bleeding from the superior hemorrhoidal artery, underwent percutaneous fibered platinum coil embolization via coaxial catheters. Pre-procedure sigmoidoscopy had failed to identify the source of hemorrhage, because the rectum was filled with fresh blood. Embolization was technically and clinically successful in all four patients. Subsequent sigmoidoscopy confirmed the diagnoses in three patients as a solitary rectal ulcer, iatrogenic traumatic ulceration following manual evacuation, and a rectal Dieulafoy's lesion. The other case was angiographically seen to be due to a rectal angiodysplasia. Embolization is an effective procedure in life-threatening superior hemorrhoidal arterial bleeding when endoscopic treatment fails, and should be preferred to rectosigmoid resection.

Coagulation therapy is an effective therapeutic modality in the treatment of bleeding rectal Dieulafoy's lesions

Coagulation therapy is an effective therapeutic modality in the treatment of bleeding rectal Dieulafoy's lesions