Management of colonic Dieulafoy lesions with endoscopic mechanical techniques: report of two cases.
Although Dieulafoy lesion is generally located in the proximal stomach, other locations have been reported. We present two cases of bleeding colonic Dieulafoy in patients with chronic renal failure who were treated with mechanical methods. In the first case, an active arterial bleeding without mucosal defect was localized in the descending colon. In the second case, a protruding vessel with active bleeding was found in the transverse colon. The two patients were initially treated with epinephrine and hemostatic clips. In the second patient, an endoloop was attached to the base of the previously placed hemoclips because of rebleeding. To our knowledge, this is the first case of combined endoscopic approach with hemostatic clips and endoloop to treat a colonic Dieulafoy lesion. Colonic Dieulafoy lesions reported in the relevant literature and the hemostatic treatments used are reviewed.
Department of Gastroenterology, University Hospital of the Canary Islands, Santa Cruz de Tenerife, Spain.
Antonio Z
AZ
Gimeno-García
Adolfo
A
Parra-Blanco
David
D
Nicolás-Pérez
Juan A
JA
Ortega Sánchez
Carlos
C
Medina
Enrique
E
Quintero
D000368:Aged; D001165:Arteriovenous Malformations / Q000473:pathology / Q000628:therapy*; D003108:Colonic Diseases / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000473:pathology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments; D016896:Treatment Outcome