Recurrent bleeding from a Dieulafoy’s lesion of the cecum – a case report

Czech version

Authors: M. Tomáš; P. Hříbek ; T. Grega ; Zuzana Vacková ; J. Csomor ; Štěpán Suchánek ; Petr Urbánek
Authors‘ workplace: Interní klinika 1. LF UK a ÚVN – VFN Praha
Published in: Gastroent Hepatol 2026; 80(1): 65-68
Category: Digestive Endoscopy: Case Report
doi: https://doi.org/10.48095/ccgh202665

Overview

We present a case report of recurrent bleeding from a Dieulafoy’s lesion in the cecum. This is a rare cause of bleeding into the lower gastrointestinal tract, clinically manifesting from minor to massive bleeding with the development of severe microcytic anemia requiring hospitalization and blood transfusion. Diagnosis and therapy are based on endoscopic examination of the lower digestive tract and are considerably limited by the intermittent nature of the bleeding, which often results in false negative findings. Treatment is based on achieving hemostasis utilizing endoscopic methods such as adrenaline injection, argon plasma coagulation, and using hemoclips. Only a few case reports of Dieulafoy’s lesions in the colon have been described in the available literature. Even though the lesion is rare, it is necessary to consider it in the differential diagnosis of anemia, especially in cases with negative results of the initial endoscopic examination.

Keywords:

endoscopy – Dieulafoy’s lesion – bleeding – colon

Sources

1. Lee YT, Walmsley RS, Leong RW et al. Dieulafoy’s lesion. Gastrointest Endosc 2003; 58 (2): 236–243. doi: 10.1067/mge.2003.328.

2. Khan S, Niaz S, Singh R et al. Dieulafoy lesion of the colon: a rare finding during colonoscopy. Cureus 2022; 14 (5): e25188. doi: 10.7759/ cureus.25188.

3. Dokmak A, Muso E. Gastrointestinal bleeding from Dieulafoy’s lesion in the cecum. Case Rep Gastroenterol 2022; 16 (3): 601–606. doi: 10.1159/000525740.

4. Jeon HK, Kim GH. Endoscopic management of Dieulafoy’s lesion. Clin Endosc 2015; 48 (2): 112–120. doi: 10.5946/ce.2015.48.2.112.

5. Barbier P, Luder P, Triller J et al. Colonic hemorrhage from a solitary minute ulcer. Gastroenterology 1985; 88 (4): 1065–1068. doi: 10.1016/ s0016-5085 (85) 80030-5.

6. Karstensen JG, Ebigbo A, Aabakken L et al. Nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) cascade guideline. Endosc Int Open 2018; 6 (10): E1256–E1263. doi: 10.1055/a-0677 -⁠ 2084.

7. Inayat F, Hussain A, Yahya S et al. Rectal Dieulafoy’s lesion: a comprehensive review of patient characteristics, presentation patterns, diagnosis, management, and clinical outcomes. Transl Gastroenterol Hepatol 2022; 7 : 10. doi: 10.21037/tgh.2020.02.17.

8. Baxter M, Aly E. Dieulafoy’s lesion: current trends in diagnosis and management. Ann R Coll Surg Engl 2010; 92 (7): 548–554. doi: 10.1308/003588410X12699663905311.

9. Ma C, Hundal R, Cheng EJ. Colonic Dieulafoy’s lesion: a rare cause of lower gastrointestinal hemorrhage and review of endoscopic management. Case Rep Gastrointest Med 2014; 2014 : 436293. doi: 10.1155/2014/436293.

10. Macrì A, Saladino E, Versaci A et al. Massive bleeding from a Dieulafoy’s lesion of the duodenum successfully treated with “adjuvant” transarterial embolization and endoscopic laser coagulation. Acta Chir Belg 2010; 110 (2): 208–209. doi: 10.1080/00015458.2010.116 80599.

11. Nojkov B. Distinctive aspects of peptic ulcer disease, Dieulafoy’s lesion, and Mallory-Weiss syndrome in patients with advanced alcoholic liver disease or cirrhosis. World J Gastroenterol 2016; 22 (1): 446–466. doi: 10.3748/wjg.v22.i1.446.

Doručeno/Submitted: 27. 10. 2025

Přijato/Accepted: 19. 11. 2025

Korespondenční autor

MUDr. Petr Hříbek, Ph.D.

Interní klinika

1. LF UK a ÚVN –⁠ VFN Praha

U Vojenské nemocnice 1200/1

169 02 Praha 6

petr.hribek@uvn.cz