Clin Endosc.  2014 Jul;47(4):362-366. 10.5946/ce.2014.47.4.362.

Endoscopic Management of Rectal Dieulafoy's Lesion: A Case Series and Optimal Treatment

• Park JG
• Park JC
• Kwon YH
• Ahn SY
• Jeon SW

• KMID: 1907940
• DOI: http://doi.org/10.5946/ce.2014.47.4.362

Abstract

Rectal Dieulafoy's lesion (DL) is rare cause of lower gastrointestinal bleeding. Because of its rarity, there is no consensus on the optimal endoscopic hemostasis technique for rectal DL. We analyzed six patients who underwent endoscopic management for rectal DL after presenting with hematochezia at a single institute over 10 years. Of the six patients, three underwent endoscopic band ligation (EBL) and three underwent endoscopic hemoclip placement (EHP). Only one patient was treated with thermocoagulation. There were no immediate complications in any of the patients. None of the patients required a procedure or surgery for the treatment of rebleeding. Mean procedure times of EBL and EHP were 5.25 minutes and 7 minutes, respectively. Both EHP and EBL are shown to be effective in the treatment of bleeding rectal DL. We suggest that EBL may have potential as the preferred therapy owing to its superiority in technical and economic aspects, especially in elderly and high-risk patients.

Keyword

Rectal dieulafoy's lesion; Hemostasis, endoscopic; Gastrointestinal hemorrhage

MeSH Terms

Aged
Consensus
Electrocoagulation
Gastrointestinal Hemorrhage
Hemorrhage
Hemostasis, Endoscopic
Humans
Ligation

Figure

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  Fig. 1 (A) A protruding vessel was surrounded by an almost normal mucosa without active bleeding near the and verge. (B) Rectal Dieulafoy's lesion was treated successfully with endoscopic hemostasis using band ligation.

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  Fig. 2 (A) A protruding vessel was surrounded by a small shallow ulceration without active bleeding near the anal verge. (B) Rectal Dieulafoy's lesion was treated successfully using endoscopic hemoclip placement.

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