Rectal dieulafoy-like lesion complicated by an ischemic ulcer after successful endoscopic injection-therapy with dilute epinephrine in hypertonic glucose water

SUMMARY Dieulafoy’s lesion is an unusual source of massive lower gastrointestinal hemorrhage. It is characterized by severe bleeding from a minute submucosal arteriole that bleeds through a punctate erosion in an otherwise normal mucosa. Although Dieulafoy’s lesions were initially described only in the stomach and upper small intestine, they are being identified with increasing frequency in the colon and rectum. We describe a young patient who presented with severe lower gastrointestinal bleeding caused by a rectal Dieulafoy-like lesion. This is the first report of a rectal Dieulafoy-like lesion treated successfully with endoscopic epinephrine plus hypertonic glucose water (50%GW) injection and complicated by an ischemic ulcer. Key words: Dieulafoy’s lesion, Epinephrine, Hypertonic Glucose Water (50%GW)