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
(Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar)
Am J Case Rep 2017; 18:677-681
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