Dieulafoy Lesion of the Colon: A Rare Finding During Colonoscopy

Abstract

Dieulafoy lesions are common dilated submucosal vessels that can present with gastrointestinal (GI) bleeding. These lesions are usually found in the stomach or esophagus and colonic Dieulafoy lesions are very rare. Clinical presentation can vary from mild non-threatening GI bleeding to massive and recurrent hemorrhage. Here, we discuss a case of a 71-year-old female patient who presented with a bright red bleed per rectum. Colonoscopy was performed, which revealed a bleeding Dieulafoy lesion in the descending colon with clotted blood in the transverse and descending colon. In this article, we will also review the literature related to the epidemiology, clinical presentation, diagnosis, and management of Dieulafoy lesions.

Rare Colonic Dieulafoy Lesions: A Case Series

“…This suggests these lesions are likely acquired defects; however, there is little data to support this hypothesis [5]. The diagnosis can be challenging due to the presence of diverticula, bleeding cessation prior to diagnostic endoscopy, and difficulty locating the lesion in the setting of poor bowel prep [7][8][9]. The lesions present with acute, painless, severe hematemesis, melena, and/or hematochezia, with 51% presenting with hematemesis and melena.…”

Gastrointestinal Bleeding From a Transverse Colon Dieulafoy Lesion

“…These lesions are typically present in the upper gastrointestinal tract, and extragastric Dieulafoy lesions are extremely rare [ 1 ]. It is diagnosed endoscopically, as our case shows: densely adherent blood clots and active bleeding from a minute mucosal defect; in the quiescent phase: the mucosal defect is extremely small, with normal surrounding mucosa and no inflammation.…”

“…Dieulafoy lesions are an uncommon and potentially serious gastrointestinal bleeding disease. They account for about 1-2% of gastrointestinal bleeding, 80% of which are located in the upper gastrointestinal tract and less than 2% in the colorectum [ 1 ]. Lower gastrointestinal bleeding caused by a transverse colonic Dieulafoy lesion is extremely rare [ 2 ].…”