Rectal dieulafoy lesion managed by hemostatic clips

Area of Science:

• Gastroenterology
• Endoscopy
• Vascular Malformations

Background:

• Dieulafoy lesions are typically found in the upper gastrointestinal tract.
• They present as minute mucosal defects with exposed arteries, leading to massive bleeding.
• Classic endoscopic findings include a round defect with a protruding artery without surrounding ulceration.

Observation:

• An 89-year-old male presented with sudden, massive rectal bleeding.
• Colonoscopy revealed a Dieulafoy lesion in the rectum as the source of hemorrhage.
• The lesion required careful irrigation and inspection for identification.

Findings:

• Successful hemostasis was achieved using endoscopic interventions.
• Epinephrine injection was utilized to control the bleeding.
• Endoscopic hemostatic clipping provided a definitive solution for the Dieulafoy lesion.

Implications:

• This case expands the known anatomical locations for Dieulafoy lesions.
• It highlights the importance of considering Dieulafoy lesions in lower gastrointestinal bleeding.
• Endoscopic management is a viable and effective treatment for rectal Dieulafoy lesions.