Rectal Dieulafoy Lesion with Severe Hematochezia in a Warfarin-Treated Patient

Authors

• Carlos Elizondo Alatorre, Department of Medicine, NYC Health + Hospitals/Metropolitan, New York, NY, USAFollow
• Maria Gabriela Rubianes Guerrero, Division of Gastroenterology and Hepatobiliary diseases, NYC Health + Hospitals/Metropolitan, New York, NY, USA
• Julio C Valencia Manrique, Division of Gastroenterology and Hepatobiliary diseases, NYC Health + Hospitals/Metropolitan, New York, NY, USA
• Jennifer Harley, Division of Gastroenterology and Hepatobiliary diseases, NYC Health + Hospitals/Metropolitan, New York, NY, USA

Abstract

Dieulafoy lesions (DLs) are rare vascular malformations in the gastrointestinal tract that often present with gastrointestinal bleeding, most commonly in the stomach. Rectal DLs are exceptionally rare, representing less than 2% of cases. Warfarin use increases the risk for bleeding and management represents a challenge. We present a case of a 60-year-old male on chronic warfarin therapy who presented with severe hematochezia due to a rectal DL, requiring more than one colonoscopy and prothrombin complex concentrate (PCC) administration. While guidelines recommend PCC over fresh frozen plasma (FFP), they acknowledge that this is based on very low certainty of evidence.

Recommended Citation

Alatorre, Carlos Elizondo; Guerrero, Maria Gabriela Rubianes; Valencia Manrique, Julio C; and Harley, Jennifer (2026) "Rectal Dieulafoy Lesion with Severe Hematochezia in a Warfarin-Treated Patient," Journal of Community Hospital Internal Medicine Perspectives: Vol. 16: Iss. 4, Article 19.
DOI: https://doi.org/10.55729/2000-9666.1625
Available at: https://scholarlycommons.gbmc.org/jchimp/vol16/iss4/19

DOI

10.55729/2000-9666.1625