Dieulafoy lesion in a Hartmann stump

A 70‐year‐old man underwent laparoscopic anterior resection for sigmoid carcinoma, and on postoperative day 4, he required an emergency Hartmann procedure for bowel ischemia and anastomotic leakage. Five days after the emergency procedure, there was a massive hemorrhage through the anus that appeare...

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Bibliographic Details
Published in:Asian journal of endoscopic surgery 2020-10, Vol.13 (4), p.560-563
Main Authors: Gundogan, Ersin, Karabulut, Ertugrul, Ersan, Veysel, Kayaalp, Cuneyt
Format: Article
Language:English
Subjects:
colon cancer
Colonoscopy
Colorectal cancer
endoscopic treatment
Endoscopy
Hemorrhage
lower gastrointestinal hemorrhage
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Summary:A 70‐year‐old man underwent laparoscopic anterior resection for sigmoid carcinoma, and on postoperative day 4, he required an emergency Hartmann procedure for bowel ischemia and anastomotic leakage. Five days after the emergency procedure, there was a massive hemorrhage through the anus that appeared in the abdominal drain. During exploration, the origin of the bleeding could not be found, and the rectal stump was closed over a urinary Foley catheter (with an inflated balloon) with the help of a purse‐string suture. In the intensive care unit, massive hematochezia continued. Emergency transanal colonoscopy to the Hartmann stump found the rectum full of clotted blood. Active pulsatile arterial bleeding of a rectal Dieulafoy lesion was detected. After endoscopic hemostasis efforts failed, bleeding was stopped successfully by transanal suturing. The patient was discharged without any other problems, and no recurrent bleeding occurred during the 18‐month follow‐up. Here, we report a rectal Dieulafoy lesion in a Hartmann stump for the first time.
ISSN:1758-5902
1758-5910
DOI:10.1111/ases.12781