Rectal bleeding by Dieulafoy-like lesion: successful endoscopic treatment

Casella, Giovanni and Bonforte, Giuseppe and Corso, Rocco and Buda, Carmelo Antonio and Corti, Gianluigi L. and Gambareri, A. Roberto and Magrì, Filippo and Baldini, Vittorio (2005) Rectal bleeding by Dieulafoy-like lesion: successful endoscopic treatment. Il giornale di chirurgia, 26 (11/12). pp. 415-418. ISSN 1971-145x

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A 81-year old woman affected by chronic renal failure, non insulin-dependent diabetes mellitus (NIDM) and hypertension, had an severe anemia massive hematochezia. The colonoscopy could not localize the bleeding site except some blood spots in the rectum. The patient was readmitted after 1 month with hypovolemic shock by massive hematochezia and required several blood transfusions. The endoscopic examination showed an important arterial bleeding treated successfully with epinephrine and bipolar elettro-coagulation (BICAP). We suggested that the patient presented a Dieulafoy-like lesion; this is an uncommon gastrointestinal cause of bleeding due to a defect of a submucosal artery without evidence of atherosclerosis or vasculitis. Both chronic renal failure and age could be considered as predisponent factors in this patient. Hematochezia is the most important sign and is often complicated by haemorrhagic shock. The diagnosis was delayed due to the difficulty in localizing the bleeding site; moreover, the patient needed several blood transfusions. The arteriographic diagnosis associated to endoscopic treatment by epinephrine and BICAP enabled a successful therapy.

Item Type: Article
Uncontrolled Keywords: Rectal Dieulafoy-like lesion, Rectal bleeding,Endoscopic therapy; Ulcera rettale simil-Dieulafoy, Sanguinamento rettale, Terapia endoscopica
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Chiara D'Arpa
Date Deposited: 03 Sep 2014 09:01
Last Modified: 03 Sep 2014 09:01

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