https://www.giejournal.org/article/S0016-5107%2803%2980118-9/pdf

Dieulafoy's lesion.

Although Dieulafoy lesion is generally located in the proximal stomach, other locations have been reported. We present two cases of bleeding colonic Dieulafoy in patients with chronic renal failure who were treated with mechanical methods. In the first case, an active arterial bleeding without mucosal defect was localized in the descending colon. In the second case, a protruding vessel with active bleeding was found in the transverse colon. The two patients were initially treated with epinephrine and hemostatic clips. In the second patient, an endoloop was attached to the base of the previously placed hemoclips because of rebleeding. To our knowledge, this is the first case of combined endoscopic approach with hemostatic clips and endoloop to treat a colonic Dieulafoy lesion. Colonic Dieulafoy lesions reported in the relevant literature and the hemostatic treatments used are reviewed.

Management of Colonic Dieulafoy Lesions With Endoscopic Mechanical Techniques: Report of Two Cases

Dieulafoy's lesion (DL) is a persistently wide caliber artery that is observed more frequently at the fifth decade of life in the male population with multiple comorbidities. There are a variety of endoscopic therapies that have been used to treat DL; however, there are no clear guidelines on the best treatment modality. This article systematically reviews the diagnosis, the most commonly reported therapies of DL, and offers a suggested algorithm based upon efficacy of treatment such as initial hemostasis, rebleeding rates, and mortality.

The Dieulafoy's Lesion: An Update on Evaluation, Diagnosis, and Management.

Dieulafoy’s lesion is a rare cause of gastrointestinal (GI) bleeding comprising approximately 2% of all acute GI bleeds. It is an abnormal submucosal artery that has a tortuous course before protruding through the mucosa and leading to hemorrhage. Dieulafoy’s lesions are most commonly located in the upper GI tract within the lesser curvature of the stomach. Lower GI tract Dieulafoy’s lesions are remarkably rare. Our case describes an elderly gentleman who presented with fatigue and dyspnea several days prior to experiencing any evidence of GI bleeding. Initial laboratory investigation revealed severe anemia, requiring packed red blood cell transfusion. Endoscopic examination revealed a cecal Dieulafoy’s lesion with active spurting of blood. Hemostasis was achieved through local epinephrine injection and hemostatic clipping. Previously reported cases of cecal Dieulafoy’s lesions involve variable presentations including hematochezia, melena, or bright red blood per rectum. These lesions can be treated by angiography, surgically, or endoscopically via techniques that include epinephrine or ethanol injection, argon plasma coagulation, heater probe coagulation, hemostatic clips, or band ligation. Dieulafoy’s lesions of the lower GI tract should be considered when no clear culprit is discovered, particularly with the concomitant use of antiplatelet agents and anticoagulants.

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Gastrointestinal Bleeding from Dieulafoy's Lesion in the Cecum

Dieulafoy’s lesion is an uncommon but important cause of gastrointestinal bleeding, especially with respect to the upper gastrointestinal tract wherein massive, life-threatening haemorrhage occurs from a calibre-persistent submucosal artery. This report describes a case of a 60-year-old man with gastric Dieulafoy’s lesion presenting with exogastric haemorrhage, which was diagnosed following a pathological examination.

S. Mazumdar

Papers

Dieulafoy's lesion of the cecum: A rare cause of lower GI hemorrhage