Abstract

SANDOVAL-MONTERO, Jorge; BARBOZA-PORRAS, Shirley  and  VARGAS-MADRIGAL, Jorge. Lesion of cecal Dieulafoy: an unusual cause of recurrent severe rectal bleeding. Endoscopia [online]. 2019, vol.31, n.2, pp.85-89.  Epub Oct 25, 2021. ISSN 2444-6483.  https://doi.org/10.24875/end.19000003.

Dieulafoy lesion consists in the persistence of the caliber of a submucosal artery until it protrudes on a normal mucosal; its location in the colon is very unusual and occurs in only 2% of the cases. We present the case of a 30-year-old man, with no other illness, referred because of severe rectal bleeding, with a normal initial esophagogastroduodenoscopy, and an initial colonoscopy where a 20 mm pedunculated polyp without recent bleeding signs was detected, covered with blood stains. Due to this finding colonoscopy was repeated in 48 hours and polyp was resected, with adequate hemostasis. Patient reconsulted for severe rectal bleeding, for this reason a new colonoscopy was performed, finding a vascular lesion in the cecum compatible with a Dieulafoy lesion, which was coagulated with argon plasma after an initial failure of hemostasis with coagulation forceps. The main treatment is endoscopic, with surgery being an option in patients who can’t be controlled by endoscopy, although in patients who are not surgical candidates, angiography could be considered an option.

Keywords : Dieulafoy lesion; Severe rectal bleeding; Argon plasma coagulation (APC).