scholarly journals Colonic Dieulafoy’s Lesion: A Rare Cause of Lower Gastrointestinal Hemorrhage and Review of Endoscopic Management

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Christopher Ma ◽  
Rajveer Hundal ◽  
Edwin J. Cheng
Keyword(s):  
Gastrointestinal Bleeding ◽  
Gastrointestinal Hemorrhage ◽  
Endoscopic Management ◽  
Rare Entity ◽  
Fresh Blood ◽  
Nonvalvular Atrial Fibrillation ◽  
Lower Gastrointestinal Hemorrhage ◽  
Dieulafoy’S Lesion ◽  
Upper Gi ◽  
Life Threatening

Dieulafoy’s lesions are a rare cause of gastrointestinal hemorrhage. Extragastric Dieulafoy’s lesions are even more uncommon. We report the case of a 75-year-old woman who presented with gastrointestinal bleeding from a transverse colonic Dieulafoy’s lesion. She presented with two episodes of melena followed by one episode of fresh blood per rectum. In addition, there was associated presyncope and anemia (hemoglobin 69 g/L) in the setting of supratherapeutic warfarin anticoagulation (INR 6.2) for nonvalvular atrial fibrillation. Esophagogastroduodenoscopy was negative for an upper GI source of bleeding but on colonoscopy an actively oozing Dieulafoy’s lesion was identified in the transverse colon. Bipolar cautery and hemostatic endoclips were applied to achieve hemostasis. Clinicians should consider this rare entity as a potential cause of potentially life-threatening lower gastrointestinal bleeding and we review the endoscopic modalities effective for managing colonic Dieulafoy’s lesions.

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

2019 ◽  
Vol 13 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Eric Omar Then ◽  
Rani Bijjam ◽  
Andrew Ofosu ◽  
Prashanth Rawla ◽  
Andrea Culliford ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Gastrointestinal Hemorrhage ◽  
Lower Gastrointestinal Bleeding ◽  
Rare Presentation ◽  
Lower Gastrointestinal Hemorrhage ◽  
Dieulafoy’S Lesion ◽  
Life Threatening ◽  
Submucosal Vessel ◽  
Upper Gastrointestinal

A Dieulafoy’s lesion is defined as a dilated submucosal vessel that erodes the overlying epithelium without evidence of a primary ulcer or erosion. It is a rare cause of gastrointestinal bleeding that is difficult to identify and subsequently manage. Most commonly, they occur in the upper gastrointestinal tract, namely the stomach. A Dieulafoy’s lesion of the rectum, however, is an exceedingly rare presentation that can lead to life-threatening gastrointestinal bleeding. Our case consists of an 84-year-old man, who presented with lower gastrointestinal bleeding secondary to a Dieulafoy’s lesion of the rectum.

scholarly journals Atypical Presentation of Colonic Diverticular Disease

2021 ◽  
Vol 33 (1) ◽  
pp. 94-98
Author(s):  
Refaya Tasnim ◽  
Nawsabah Noor ◽  
Quazi Tarikul Islam
Keyword(s):  
Gastrointestinal Bleeding ◽  
Diverticular Disease ◽  
Lower Gastrointestinal Bleeding ◽  
Common Finding ◽  
Fresh Blood ◽  
Colonic Diverticulosis ◽  
Infectious Colitis ◽  
Colonic Neoplasia ◽  
Life Threatening ◽  
Colonic Diverticular Disease

Hematochezia or passage of fresh blood per rectum is a relatively common finding in medical practice which mostly indicates lower gastrointestinal bleeding. The causes for lower gastrointestinal bleeding include diverticular disease, vascular ectasia, ischemic, inflammatory or infectious colitis, colonic neoplasia, hemorrhoids, anal fissures and small bowel lesions (Crohn’s disease, Vascularectasia, Meckel’s diverticulum).If a patient comes with severe hematochezia, the first and foremost task is to stabilize the patient and then find out the source of bleeding as soon as possible. Elderly patients presenting with severe hematochezia, is most likely due to colorectal malignancy but benign causes like colonic diverticulosis can also present as life threatening bleeding in rare occasions. Here we report a case of 70-years-old male patient presenting with severe painless hematochezia leading to severe anemia due to diverticulosis. Bangladesh J Medicine July 2022; 33(1) : 94-98

scholarly journals A Series of Unfortunate Events: Prinzmetal Angina Culminating in Transmural Infarction in the Setting of Acute Gastrointestinal Hemorrhage

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Michael Ruisi ◽  
Phillip Ruisi ◽  
Hugo Rosero ◽  
Paul Schweitzer
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Gastrointestinal Bleeding ◽  
Gastrointestinal Hemorrhage ◽  
Vasospastic Angina ◽  
Autonomic Activity ◽  
Drug Ingestion ◽  
Transmural Infarction ◽  
Life Threatening ◽  
Clinical Phenomenon

Prinzmetal angina or vasospastic angina is a clinical phenomenon that is often transient and self-resolving. Clinically it is associated with ST elevations on the electrocardiogram, and initially it may be difficult to differentiate from an acute myocardial infarction. The vasospasm induced in this setting occurs in normal or mildly to moderately diseased vessels and can be triggered by a number of etiologies including smoking, changes in autonomic activity, or drug ingestion. While the ischemia induced is usually transient, myocardial infarction and life-threatening arrhythmias can occur in 25% of cases. We present the case of a 65-year-old female where repetitive intermittent coronary vasospasm culminated in transmural infarction in the setting of gastrointestinal bleeding. This case highlights the mortality associated with prinzmetal angina and the importance of recognizing the underlying etiology.

scholarly journals Rectal Dieulafoy’s Lesion: An Underrecognized Cause of Lower Gastrointestinal Bleeding

2017 ◽  
Vol 08 (04) ◽  
pp. 202-204
Author(s):  
Vipul D. Yagnik
Keyword(s):  
Blood Loss ◽  
Gastrointestinal Bleeding ◽  
Alimentary Tract ◽  
Clinical Presentation ◽  
Lower Gastrointestinal Bleeding ◽  
Hospitalized Patients ◽  
Gi Bleeding ◽  
Dieulafoy’S Lesion ◽  
Threatening Condition ◽  
Life Threatening

ABSTRACTDieulafoy’s lesion is a rare but potentially a life-threatening condition. It accounts for 1%–2% of acute gastrointestinal (GI) bleeding. The lesion is most frequently located in the stomach and may be located anywhere in the alimentary tract. It can be present as severe GI bleeding or chronic GI blood loss. The cause of lesion remains uncertain. The range of clinical presentation varies from acute ill hospitalized patients as well as in the newborn.

scholarly journals Over-the-Scope Clip to the Rescue! A Novel Tool for Refractory Acute Nonvariceal Upper Gastrointestinal Hemorrhage

2020 ◽  
Vol 14 (2) ◽  
pp. 261-270 ◽  
Author(s):  
Shivantha Amarnath ◽  
Jobin Philipose ◽  
Jeffrey Abergel ◽  
Hafiz Khan
Keyword(s):  
Gastrointestinal Hemorrhage ◽  
The Elderly ◽  
Endoscopic Management ◽  
Upper Gastrointestinal Hemorrhage ◽  
Lower Gastrointestinal Hemorrhage ◽  
Epinephrine Injection ◽  
Cardiovascular Comorbidities ◽  
Risk Of Mortality ◽  
Endoscopic Methods ◽  
Upper Gastrointestinal

Nonvariceal upper gastrointestinal hemorrhage (NVUGIH) is more prevalent than lower gastrointestinal hemorrhage and carries a high risk of mortality in the elderly, especially those with significant cardiovascular comorbidities. Traditional endoscopic methods, such as through-the-scope clips, electrocautery, and epinephrine injection, are frequently used to control these bleeds; however, they carry a 10% risk of rebleeding, and this itself carries a mortality risk of 36%. The larger over-the-scope clips (OTSC) that were initially used for the closure of fistulas and perforations are now gradually being implemented to manage NVUGIH. To our knowledge, we present the first cases to be reported in the literature where OTSC was successfully used as salvage therapy for refractory acute upper gastrointestinal bleeders who failed traditional endoscopic management and interventional radiology-guided embolization of the bleeding artery. We also provide an up-to-date literature review on the use of OTSC and its superiority to traditional endoscopic interventions in the management of complicated NVUGIH.

scholarly journals Finding the Dieulafoy’s Lesion: A Case of Recurrent Rectal Bleeding in an Immunosuppressed Patient

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Caleb Hudspath ◽  
Dylan Russell ◽  
Ki Eum ◽  
Joel Guess ◽  
Jessica Bunin ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Immunosuppressive Treatment ◽  
Arterial Embolization ◽  
Immunosuppressed Patient ◽  
Vascular Abnormality ◽  
Dieulafoy’S Lesion ◽  
Acute Gastrointestinal Bleeding ◽  
Life Threatening ◽  
Lower Gastrointestinal Bleed

A Dieulafoy’s lesion (DL) is rare cause of acute gastrointestinal bleeding defined as a vascular abnormality of the submucosa. With a high prevalence for the stomach and upper gastrointestinal tract, it is rarely observed in the lower gastrointestinal tract. Its prevalence is rare accounting for less than 2% of all cases of acute gastrointestinal bleeding. The etiology of DL is unknown. Common comorbidities include cardiovascular disease, kidney disease, diabetes, alcohol abuse, liver disease, and chronic NSAID use. Few cases involving chronic steroid use and immunosuppressive treatment have been reported. The most common diagnostic and treatment modality is endoscopy with refractory cases treated with arterial embolization by angiography. We present a case involving a patient with significant comorbidities on chronic immunosuppression with a life-threatening, massive lower gastrointestinal bleed from a DL in the rectum.

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