Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
권호 표지
DOI QR코드

DOI QR Code

Massive bleeding from a rectal Dieulafoy lesion in a patient with alcoholic cirrhosis

  • Choi, Young Hoon (Department of Internal Medicine, Myongji Hospital, Seonam Univeristy College of Medicine) ;
  • Eun, Jong Ryeol (Department of Internal Medicine, Myongji Hospital, Seonam Univeristy College of Medicine) ;
  • Han, Jae Ho (Department of Internal Medicine, Myongji Hospital, Seonam Univeristy College of Medicine) ;
  • Lim, Hyun (Department of Internal Medicine, Myongji Hospital, Seonam Univeristy College of Medicine) ;
  • Shin, Jung A (Department of Internal Medicine, Myongji Hospital, Seonam Univeristy College of Medicine) ;
  • Lee, Gun Hwa (Department of Internal Medicine, Myongji Hospital, Seonam Univeristy College of Medicine) ;
  • Lee, Seung Hee (Department of Internal Medicine, Myongji Hospital, Seonam Univeristy College of Medicine)
  • Received : 2015.08.08
  • Accepted : 2015.09.30
  • Published : 2017.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Although Dieulafoy lesion can occur in any part of the gastrointestinal tract, its occurrence in the rectum is rare. Rectal Dieulafoy lesions have been associated with advanced age, renal failure, burns, liver transplantation and cirrhosis. Here, we report on a case of massive bleeding from a rectal Dieulafoy lesion after lung decortication surgery in a 57-year-old male patient with alcoholic cirrhosis. Although rare, a rectal Dieulafoy lesion should be included in the differential diagnosis of massive lower gastrointestinal bleeding in a patient with cirrhosis.

Keywords

References

  1. Cremers I, Ribeiro S. Management of variceal and nonvariceal upper gastrointestinal bleeding in patients with cirrhosis. Therap Adv Gastroenterol 2014;7:206-16. https://doi.org/10.1177/1756283X14538688
  2. Garcia-Tsao G, Sanyal AJ, Grace ND, Carey W; Practice Guidelines Committee of the American Association for the Study of Liver Diseases; Practice Parameters Committee of the American College of Gastroenterology. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology 2007;46:922-38. https://doi.org/10.1002/hep.21907
  3. Harrison JD, Calatayud A, Thava VR, Kirby RM. Massive arterial bleeding from a single rectal vessel. Postgrad Med J 1997;73:303-4. https://doi.org/10.1136/pgmj.73.859.303
  4. Lee YT, Walmsley RS, Leong RW, Sung JJ. Dieulafoy’s lesion. Gastrointest Endosc 2003;58:236-43. https://doi.org/10.1067/mge.2003.328
  5. Kim HH, Kim JH, Kim SE, Park SJ, Park MI, Moon W. Rectal dieulafoy lesion managed by hemostatic clips. J Clin Med Res 2012;4:439-41.
  6. Kim M, Song HJ, Kim S, Cho YK, Kim HU, Song BC, et al. Massive life-threatening lower gastrointestinal hemorrhage caused by an internal hemorrhoid in a patient receiving antiplatelet therapy: a case report. Korean J Gastroenterol 2012;60:253-7. https://doi.org/10.4166/kjg.2012.60.4.253
  7. Gimeno-Garcia AZ, Parra-Blanco A, Nicolas-Perez D, Ortega Sanchez JA, Medina C, Quintero E. Management of colonic Dieulafoy lesions with endoscopic mechanical techniques: report of two cases. Dis Colon Rectum 2004;47:1539-43. https://doi.org/10.1007/s10350-004-0615-y
  8. Guy RJ, Ang ES, Tan KC, Tsang CB. Massive bleeding from a Dieulafoy-like lesion of the rectum in a burns patient. Burns 2001;27:767-9. https://doi.org/10.1016/S0305-4179(01)00031-6
  9. Apiratpracha W, Ho JK, Powell JJ, Yoshida EM. Acute lower gastrointestinal bleeding from a dieulafoy lesion proximal to the anorectal junction post-orthotopic liver transplant. World J Gastroenterol 2006;12:7547-8. https://doi.org/10.3748/wjg.v12.i46.7547
  10. Park SH, Lee MH, Kim HS, Lee JW, Kim SJ, Chung IK, et al. A Dieulafoy-like lesion of the rectum as a cause of massive lower G-I bleeding. Korean J Gastrointest Endosc 1999;19:454-9. Korean.
  11. Treesaranuwattana S, Khemtai C. Dieulafoy’s lesion: pathology, diagnosis and treatment. Thai J Surg 2002;23:87-96.
  12. Bakka A, Rosseland AR. Massive gastric bleeding from exulceratio simplex (Dieulafoy). Acta Chir Scand 1986;152:285-8.
  13. Juler GL, Labitzke HG, Lamb R, Allen R. The pathogenesis of Dieulafoy’s gastric erosion. Am J Gastroenterol 1984;79:195-200.
  14. Baxter M, Aly EH. Dieulafoy’s lesion: current trends in diagnosis and management. Ann R Coll Surg Engl 2010;92:548-54. https://doi.org/10.1308/003588410X12699663905311