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

Then, Eric O.; Bijjam, Rani; Ofosu, Andrew; Rawla, Prashanth; Culliford, Andrea; Gaduputi, Vinaya

doi:10.1159/000497139

Cited by 12 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are also additional case reports that also present with patients having these lesions in their rectum. One report by Then et al [ 6 ] describes a patient with a similar presentation to the one in this case who had a sharp drop in hemoglobin that led to a colonoscopy. Hemostasis was achieved similarly with three hemostatic clips and an epinephrine injection to the lesion site.…”

Section: Discussionmentioning

confidence: 60%

Severe Gastrointestinal Bleed Caused by a Rectal Dieulafoy Lesion

Singh¹,

Patel²,

Patel³

et al. 2021

Cureus

View full text Add to dashboard Cite

Dieulafoy lesions are vessels that erode the overlying epithelium without the presence of an ulcer. When these lesions bleed, they can frequently be self-limited, but bleeding can be recurrent and prolonged. Although most commonly found in the lesser curvature of the proximal stomach, there are reports of these lesions in other gastrointestinal tract regions. This case identifies a Dieulafoy lesion found in the rectum, which was the source of this patient’s profuse rectal bleeding.

show abstract

Section: Discussionmentioning

confidence: 60%

Severe Gastrointestinal Bleed Caused by a Rectal Dieulafoy Lesion

Singh¹,

Patel²,

Patel³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…A pulsating vessel may become visible with surface mucosal erosion of about 1-5 mm and without any evidence of inflammation at the edge of the mucosal defect [5]. The endoscopic diagnostic criteria for DLs include the following [4]: active arterial spurting or micro-pulsatile streaming from a minute mucosal defect (< 3 mm); direct visualization of the protruding vessel with or without active bleeding within the mucosal defect with normal mucosa along the periphery; evidence of a densely adherent clot with a narrow attachment point to a mucosal defect or normal-appearing mucosa. However, there is a diagnostic dilemma where on occasions the lesion may be too small to be identified and this is further affected by the relatively normal appearance of the surrounding mucosa [2].…”

Section: Discussionmentioning

confidence: 99%

“…The latter most commonly involves the stomach (75%-95% of cases), especially within 6 cm of the gastroesophageal junction [1]. Arterial supply of this region comes directly from the branches of the left gastric artery [4]. There are also isolated cases of DLs that occur in the duodenum, colon, and even the rectum [5].…”

Section: Introductionmentioning

confidence: 99%

A Tale of Three Dieulafoy Lesions: A Case Report and Review of the Literature

Amarnath

Ghimire

Khan

2020

Cureus

View full text Add to dashboard Cite

A Dieulafoy lesion (DL) is a rare cause of non-variceal upper gastrointestinal hemorrhage. It is a large submucosal artery that lies in close proximity to the mucosal surface without any evidence overlying superficial ulcers. DLs can be found anywhere within the gastrointestinal (GI) tract, but are frequently encountered within the stomach. Most cases documented in the literature only describe isolated, single DLs occurring within the GI tract. Herein, we describe an unusual case of an elderly female with a medical history of compensated alcoholic liver cirrhosis who presented with massive hematemesis and endoscopy unveiled three DLs within the gastric cardia as the source of hemorrhage. The bleeding was successfully managed using novel endoscopic modalities such as Hemospray (Cook Medical, Bloomington, IN). We also provide an updated literature review on the diagnosis, pathophysiology as well as recent advances in the management of DLs.

show abstract

“…Several patients were admitted to the hospital for causes other than the gastrointestinal hemorrhage. They either experienced bleeding from rectal Dieulafoy's lesion during their hospital stay or were diagnosed on incidental colonoscopy performed as a part of the diagnostic workup of other medical conditions (35)(36)(37)(38)(39)(40). The bleeding episodes in a number of cases were mild and self-limiting.…”

Section: Clinical Presentationmentioning

confidence: 99%

Rectal Dieulafoy’s lesion: a comprehensive review of patient characteristics, presentation patterns, diagnosis, management, and clinical outcomes

Inayat¹,

Hussain²,

Yahya³

et al. 2022

Transl Gastroenterol Hepatol

View full text Add to dashboard Cite

Dieulafoy's lesion is an abnormally large, tortuous, submucosal vessel that erodes the overlying mucosa, without primary ulceration or erosion. Although these lesions predominantly involve the stomach and upper small intestine, they are being detected with increasing frequency in the rectum. We conducted a systematic literature search of MEDLINE, Cochrane, Embase, and Scopus databases for adult rectal Dieulafoy's lesion. After careful review of the search results, a total of 101 cases were identified. The data on patient characteristics, clinical features, colonoscopy findings, diagnosis, treatment, and clinical outcomes were collected and analyzed. The mean age of presentation was 66±17 years (range, 18-94 years), with 54% of cases reported in males. Clinical presentation was dominated by acute lower gastrointestinal bleeding in the form of bright-red blood per rectum 47% and hematochezia 36%, whereas 16% of patients were admitted with symptoms related to other medical conditions. Major underlying disorders were hypertension 29%, diabetes mellitus 21%, and chronic kidney disease 16%. The average number of colonoscopies required for the diagnosis of rectal Dieulafoy's lesion was 1.5±0.7. In regard to treatment, endoscopic therapy was applied in 80%, direct surgical suturing in 12%, angiographic embolization in 4%, and endoscopic therapy followed by surgical ligation was performed in 4% of patients. The endoscopic treatment was a feasible choice for rectal disease, with a primary hemostasis rate of 88%. Although the overall mortality rate was 6%, the causes of death were unrelated to this entity. This review illustrates that patients with rectal Dieulafoy's lesion can have a favorable clinical outcome. Prompt diagnosis and appropriate management are of paramount importance to prevent serious hemodynamic complications. The best therapeutic modality remains to be determined but the data presented here support the use of mechanical endoscopic methods as safe and effective.

show abstract

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

Cited by 12 publications

References 14 publications

Severe Gastrointestinal Bleed Caused by a Rectal Dieulafoy Lesion

Severe Gastrointestinal Bleed Caused by a Rectal Dieulafoy Lesion

A Tale of Three Dieulafoy Lesions: A Case Report and Review of the Literature

Rectal Dieulafoy’s lesion: a comprehensive review of patient characteristics, presentation patterns, diagnosis, management, and clinical outcomes

Contact Info

Product

Resources

About