RECTAL BLEEDING FROM A MUCOUS FISTULA SECONDARY TO A DIEULAFOYS LESION

Dieulafoy's lesion is a submucosal artery associated with a minute muc osal defect, and it is an extremely rare cause of profuse but intermit tent gastrointestinal bleeding. Most cases have occurred in the proxim al stomach within 6 cm of the gastroesophageal junction. Less commonly , cases are encountered in the antrum, duodenum, jejunum, colon, and r arely the rectum. Only three cases of rectal Dieulafoy's lesion have b een reported in the English medical literature: one in a child and two in otherwise healthy young men. We report a case of a rectal Dieulafo y's lesion in an elderly man with a mucous fistula. Successful treatme nt was administered with a combination of injection therapy and heater -probe coagulation followed by elective surgical oversewing. Rectal Di eulafoy's lesions should be included in the differential diagnosis of unexplained rectal bleeding in the elderly.