Dieulafoy lesion in the colon: a rare cause of lower gastrointestinal bleeding

Paccos, José Luiz; Mukai, Natalia Sayuri; Correa, Paulo; Marson, Fernando P.; Mota, Fernando; Oliveira, Fernando J. S.; Pereira, Eduardo Manoel

doi:10.1055/a-1270-6655

Cited by 5 publications

(2 citation statements)

References 3 publications

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“…These lesions are usually observed in the stomach. They are rarely observed in colon, and they also very rarely cause bleeding in lower gastrointestinal system (2,4). These lesions are usually diagnosed by endoscopy as an aberrant vessel (4,5).…”

Section: Resultsmentioning

confidence: 99%

Retrospective analysis of patients with Dieulafoy’s lesions

Sarıtaş

ÖLMEZ

Taş

et al. 2023

Akademik Gastroenteroloji Dergisi

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Background and Aims: Gastrointestinal bleeding is an emergent condition in clinical practice. Early diagnosis and proper treatment of the lesion is essential. Dieulafoy's lesion is an aberrant submucosal vessel eroding surrounding mucosa. These lesions cause of 1-2% of all gastrointestinal bleedings. Here we report cases with Dieulafoy's lesion presenting with upper gastrointestinal bleeding. Materials and Methods: Through a time frame of between August 2017-August 2021, patients admitted to our hospital presenting with upper gastrointestinal bleeding and diagnosed as Dieulafoy’s lesion were included in the study. Patients' files were screened retrospectively. Results: The study included 30 patients with a mean age of 65.9 ± 18.2 (20 - 92) years. Half of them were female. The most observed presentations were melena, hematemesis, and hematochezia. Associated diseases were hypertension, atherosclerotic heart disease and diabetes mellitus. In 26 (86.7%) patients, Dieulafoy's lesion was diagnosed in first endoscopy, while in four patients Dieulafoy's lesion was diagnosed in second endoscopy. Time interval between hospital admission to first endoscopy was 3.1 ± 2.5 (1 - 10) hours. In 23 patients Dieulafoy's lesion was in the stomach and in 6 patients in duodenum and in 1 patient in esophagus. Endoscopic therapy was applied to all patients. The most applied treatment modality was sclerotherapy + hemoclip application. One patient had required surgery due to recurrent bleeding. Six patients died. Three of them was bleeding related. Conclusion: Dieulafoy's lesion is a rare but serious cause of gastrointestinal bleedings. Early diagnosis and proper treatment is important. Patients may need repeated endoscopy for diagnosis. Hemoclip application is cheap, easy, safe, and effective treatment modality with/without sclerotherapy.

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