A case of the lower gastrointestinal bleeding due to Dieulafoy’s ulcer in the cecum

Abstract

Gastrointestinal Dieulafoy's ulcer is a rare disease of unknown etiology. Dieulafoy's ulcer often presents in the stomach and is thought to cause about 5% of all gastrointestinal bleeds in adults, but can be found in any part of the gastrointestinal tract. Dieulafoy's ulcer corresponds to an arterial malformation in the submucosal space and can cause life-threatening hemorrhage. We report a case of the lower gastrointestinal bleeding from a cecal Dieulafoy's ulcer that was successfully treated with endoscopic clips. An 82-year-old woman had been diagnosed with hypertension and cerebral infarction. She had been using aspirin to prevent recurrent infarction. She was admitted to our hospital with hematochezia. Urgent colonoscopy revealed a small, reddish vascular malformation in the cecum. The lesion was suggestive of Dieulafoy's ulcer and was treated with endoscopic clips. The patient has since been discharged from our hospital without experiencing any further bleeding. Endoscopy is a useful method for diagnosing and treating Dieulafoy's ulcer.

Cecal Dieulafoy lesion is a rare cause of lower gastrointestinal bleeding: A case report

“…This search yielded only 11 relevant articles consisting of 13 cases. [6][7][8][9][10][11][12][13][14][15][16] Only 3/13 cases were reported prior to 2000, which may signify increased awareness of Dieulafoy lesions as a rare cause of GI bleed (Table 1). Our case was similar to all 13 cases, which showed an average age of 67.9 ± 17.9 years and a male predominance (64.3%).…”

Gastrointestinal Bleeding from Dieulafoy’s Lesion in the Cecum

“…To our knowledge, there have been eight prior reported cases of GI bleeding secondary to a cecal Dieulafoy's lesion (Table 1 ). Disease presentation is variable with 62.5% presenting with painless hematochezia, 25% with BRBPR, and 12.5% with a mixed picture of melena and hematochezia [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Age at presentation ranged from 25 to 82 years.…”

“…Such endoscopic techniques include epinephrine or ethanol injection, argon plasma coagulation, heater probe coagulation, hemostatic clips, or band ligation [ 7 ]. Three of the previously reported cases pertaining to cecal Dieulafoy's were successfully treated mechanically with hemostatic clipping, 2 with local epinephrine injection and thermocoagulation, 1 with right hemicolectomy, 1 with combination hemostatic clipping and ethanol injection, and 1 with arterial embolization [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. When endoscopy is unsuccessful, angiography can be utilized in both Dieulafoy's lesion bleeding site localization and embolization, albeit with a risk of ischemia [ 17 ].…”