Skip to main content
Log in

A case of rectal Dieulafoy’s lesion successfully treated by transcatheter arterial embolization

  • Case report
  • Published:
Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

A 50-year-old man showed massive lower gastrointestinal bleeding without a triggering episode. An emergency colonoscopy revealed a protruding vessel in the lower rectum with no active bleeding. No underlying ulcer was seen within the surrounding mucosa. These findings were consistent with rectal Dieulafoy’s lesion. Angiography was requested to identify the source of bleeding and for possible embolization. On the initial angiography, the bleeding point was unclear. Abnormal vessels such as arteriovenous malformation or nidus were not found. He again developed hematochezia, requiring transfusion of red blood cells. However, the second colonoscopy showed no active bleeding from the protruding vessel in the rectum. During the second angiography, sudden bleeding occurred. Angiography showed extravasation of contrast medium from the distal branch of the superior rectal artery. Transcatheter arterial embolization was performed, and was very effective.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

References

  1. Nunoo-Mensah JW, Alkari B, Murphy GJ, Watson AJ. Rectal Dieulafoy lesions. J Am Coll Surg. 2008;206:388–9.

    Article  PubMed  Google Scholar 

  2. Amaro R, Petruff CA, Rogers AI. Rectal Dieulafoy’s lesion: report of a case and review of the literature. Dis Colon Rectum. 1999;42:1339–41.

    Article  PubMed  CAS  Google Scholar 

  3. Ruiz-Tovar J, Die-Trill J, Lopez-Quindos P, Rey A, Lopez-Hervas P, Devesa JM. Massive low gastrointestinal bleeding due to a Dieulafoy rectal lesion. Colorectal Dis. 2008;10:624–5.

    Article  PubMed  CAS  Google Scholar 

  4. Eisen GM, Dominitz JA, Faigel DO, Goldstein JL, Kalloo AN, Petersen BT, et al. An annotated algorithmic approach to acute lower gastrointestinal bleeding. Gastrointest Endosc. 2001;53:859–63.

    PubMed  CAS  Google Scholar 

  5. Funaki B. Superselective embolization of lower gastrointestinal hemorrhage: a new paradigm. Abdom Imaging. 2004;29:434–8.

    Article  PubMed  CAS  Google Scholar 

  6. Stark ME, Gostout CJ, Balm RK. Clinical features and endoscopic management of Dieulafoy’s disease. Gastrointest Endosc. 1992;38:545–50.

    Article  PubMed  CAS  Google Scholar 

  7. al-Mishlab T, Amin AM, Ellul JP. Dieulafoy’s lesion: an obscure cause of GI bleeding. J R Coll Surg Edinb. 1999;44:222–5.

    PubMed  CAS  Google Scholar 

  8. Kim HK, Kim JS, Son HS, Park YW, Chae HS, Cho YS. Endoscopic band ligation for the treatment of rectal Dieulafoy lesions: risks and disadvantages. Endoscopy. 2007;39:924–5.

    Article  PubMed  CAS  Google Scholar 

  9. Lee YT, Walmsley RS, Leong RW, Sung JJ. Dieulafoy’s lesion. Gastrointest Endosc. 2003;58:236–43.

    Article  PubMed  Google Scholar 

  10. 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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Diasuke Tsurumaru.

About this article

Cite this article

Nishimuta, Y., Tsurumaru, D., Komori, M. et al. A case of rectal Dieulafoy’s lesion successfully treated by transcatheter arterial embolization. Jpn J Radiol 30, 176–179 (2012). https://doi.org/10.1007/s11604-011-0029-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-011-0029-4

Keywords

Navigation