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Dieulafoy's vascular malformation as a cause of large intestinal bleeding
1Department of Histopathology, Freeman Hospital, Newcastle upon Tyne.
Insights
Dieulafoy's vascular malformation in the caecum can cause severe lower gastrointestinal bleeding. This rare condition requires consideration in patients with massive rectal bleeding, as it can be life-threatening.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Pathology
Background:
- Dieulafoy's vascular malformation is a rare cause of gastrointestinal bleeding.
- Caecal involvement is uncommon, making diagnosis and management challenging.
Observation:
- Reported four cases of Dieulafoy's vascular malformation specifically located in the caecum.
- Three cases presented with massive lower gastrointestinal hemorrhage, with one resulting in fatality.
- One case involved an incidentally discovered calibre persistent submucosal artery in a caecal resection specimen.
Findings:
- Dieulafoy's vascular malformation of the caecum is a significant cause of massive lower gastrointestinal bleeding.
- The condition can be fatal if not promptly identified and managed.
- Incidental findings in resection specimens highlight the importance of pathological examination.
Implications:
- Clinicians should consider Dieulafoy's vascular malformation of the caecum in the differential diagnosis of massive lower gastrointestinal bleeding.
- Pathologists should be aware of this entity when examining caecal resection specimens.
- Early recognition and appropriate management are crucial for improving patient outcomes and preventing mortality.
Abstract:
Four cases of Dieulafoy's vascular malformation of the caecum are reported. Three were associated with massive large bowel haemorrhage, one of which was fatal. The remaining case had a calibre persistent submucosal artery within the caecum that was found incidentally in a resection specimen. This vascular malformation should be considered when dealing with specimens resected for massive lower gastrointestinal bleeding.