Rectal dieulafoy-like lesion complicated by an ischemic ulcer after successful endoscopic injection-therapy with dilute epinephrine in hypertonic glucose water
Dieulafoys lesion is an unusual source of massive lower
gastrointestinal hemorrhage. It is characterized by severe
bleeding from a minute submucosal arteriole that bleeds
through a punctate erosion in an otherwise normal mucosa.
Although Dieulafoys lesions were initially described
only in the stomach and upper small intestine, they are being
identified with increasing frequency in the colon and
rectum. We describe a young patient who presented with
severe lower gastrointestinal bleeding caused by a rectal
Dieulafoy-like lesion. This is the first report of a rectal
Dieulafoy-like lesion treated successfully with endoscopic
epinephrine plus hypertonic glucose water (50%GW) injection
and complicated by an ischemic ulcer.
Key words: Dieulafoys lesion, Epinephrine, Hypertonic Glucose