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Dieulafoy's lesion in the cecum: A rare case report presentation

INTRODUCTION AND IMPORTANCE: Dieulafoy's lesion is a rare entity, normally present in the stomach and more rarely in the colon, and it is responsible for 1% to 5% of acute gastrointestinal bleeding cases. Its true incidence may be underrated, since most cases are asymptomatic and difficult to d...

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Autores principales: Ribeiro, Ana Matos, da Silva, Sílvia, Reis, Rui Almeida, Romero, Inês, Costa, Susana, da Silva, João Barros
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261652/
https://www.ncbi.nlm.nih.gov/pubmed/34225059
http://dx.doi.org/10.1016/j.ijscr.2021.106157
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author Ribeiro, Ana Matos
da Silva, Sílvia
Reis, Rui Almeida
Romero, Inês
Costa, Susana
da Silva, João Barros
author_facet Ribeiro, Ana Matos
da Silva, Sílvia
Reis, Rui Almeida
Romero, Inês
Costa, Susana
da Silva, João Barros
author_sort Ribeiro, Ana Matos
collection PubMed
description INTRODUCTION AND IMPORTANCE: Dieulafoy's lesion is a rare entity, normally present in the stomach and more rarely in the colon, and it is responsible for 1% to 5% of acute gastrointestinal bleeding cases. Its true incidence may be underrated, since most cases are asymptomatic and difficult to diagnose despite endoscopic advances. We present a clinical case of acute gastrointestinal bleeding due to Dieulafoy's lesion in the cecum. CASE PRESENTATION: An 85-year-old woman presented with a clinical condition of haematochezia associated with anaemia and haemodynamic instability, needing blood transfusion. Colonoscopy demonstrated a Dieulafoy's lesion in the cecum with active bleeding, and haemostasis was performed successfully with localized adrenaline injection and haemostatic clip placement. Hospitalization occurred without further complications. DISCUSSION: The diagnosis of Dieulafoy's lesion is difficult because it is a rare condition and thus, usually not included in the differential diagnosis of gastrointestinal bleeding. Its endoscopic diagnostic and therapeutic approach is the standard method in the event of an acute gastrointestinal bleeding episode, with greater efficiency with the combined use of haemostatic techniques. Surgery is necessary in less than 5% of cases when bleeding is not effectively controlled by endoscopic or angiographic techniques. CONCLUSION: It is essential to be aware of this lesion as a possible cause of gastrointestinal bleeding and differentiate it from other causes. Advances in endoscopy have increased the rate of diagnosis of these lesions and reduced their associated mortality.
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spelling pubmed-82616522021-07-16 Dieulafoy's lesion in the cecum: A rare case report presentation Ribeiro, Ana Matos da Silva, Sílvia Reis, Rui Almeida Romero, Inês Costa, Susana da Silva, João Barros Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Dieulafoy's lesion is a rare entity, normally present in the stomach and more rarely in the colon, and it is responsible for 1% to 5% of acute gastrointestinal bleeding cases. Its true incidence may be underrated, since most cases are asymptomatic and difficult to diagnose despite endoscopic advances. We present a clinical case of acute gastrointestinal bleeding due to Dieulafoy's lesion in the cecum. CASE PRESENTATION: An 85-year-old woman presented with a clinical condition of haematochezia associated with anaemia and haemodynamic instability, needing blood transfusion. Colonoscopy demonstrated a Dieulafoy's lesion in the cecum with active bleeding, and haemostasis was performed successfully with localized adrenaline injection and haemostatic clip placement. Hospitalization occurred without further complications. DISCUSSION: The diagnosis of Dieulafoy's lesion is difficult because it is a rare condition and thus, usually not included in the differential diagnosis of gastrointestinal bleeding. Its endoscopic diagnostic and therapeutic approach is the standard method in the event of an acute gastrointestinal bleeding episode, with greater efficiency with the combined use of haemostatic techniques. Surgery is necessary in less than 5% of cases when bleeding is not effectively controlled by endoscopic or angiographic techniques. CONCLUSION: It is essential to be aware of this lesion as a possible cause of gastrointestinal bleeding and differentiate it from other causes. Advances in endoscopy have increased the rate of diagnosis of these lesions and reduced their associated mortality. Elsevier 2021-06-30 /pmc/articles/PMC8261652/ /pubmed/34225059 http://dx.doi.org/10.1016/j.ijscr.2021.106157 Text en © 2021 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Ribeiro, Ana Matos
da Silva, Sílvia
Reis, Rui Almeida
Romero, Inês
Costa, Susana
da Silva, João Barros
Dieulafoy's lesion in the cecum: A rare case report presentation
title Dieulafoy's lesion in the cecum: A rare case report presentation
title_full Dieulafoy's lesion in the cecum: A rare case report presentation
title_fullStr Dieulafoy's lesion in the cecum: A rare case report presentation
title_full_unstemmed Dieulafoy's lesion in the cecum: A rare case report presentation
title_short Dieulafoy's lesion in the cecum: A rare case report presentation
title_sort dieulafoy's lesion in the cecum: a rare case report presentation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8261652/
https://www.ncbi.nlm.nih.gov/pubmed/34225059
http://dx.doi.org/10.1016/j.ijscr.2021.106157
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