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Medical Science Monitor Basic Research


Dieulafoy’s Lesion of the Anal Canal: A Rare Cause of Lower Gastrointestinal Bleeding

Unusual clinical course, Challenging differential diagnosis, Management of emergency care

Ahmed Khalid, Husham Abdelrahman, Syed Muhammad Ali, Ejaz Ahmed Latif, Hassan Al-Thani, Ayman El-Menyar

Qatar Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar

Am J Case Rep 2017; 18:677-681

DOI: 10.12659/AJCR.903735

Available online:

Published: 2017-06-17


BACKGROUND: Dieulafoy’s lesion of the anal canal is an uncommon cause of lower gastrointestinal bleeding due to rupture of a submucosal artery. This could be an under-recognized cause of hemorrhagic shock in rare cases.
CASE REPORT: We present 2 cases admitted with bleeding per rectum and hemorrhagic shock, and both were diagnosed as Dieulafoy’s lesion of the anal canal on sigmoidoscopy. One case was treated surgically and the second was managed endoscopically.
CONCLUSIONS: Dieulafoy’s lesion of the anal canal can be a source of massive lower gastrointestinal bleeding. Initial anoscopy or sigmoidoscopy might miss such a lesion. Proper visualization helps not only the diagnosis, but also the provision of therapeutic intervention in the same setting.

Keywords: Anal Canal, Endoscopy, Gastrointestinal, Gastrointestinal Diseases, Lower Gastrointestinal Tract