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Dieulafoy’s lesion of the rectum
  1. Ki Suk Eum1,
  2. Kyler Kozacek1,
  3. Caleb Hudspath1,
  4. Jessica Bunin2,
  5. Franklin Goldwire3
  1. 1 Department of Medicine, Tripler Army Medical Center, Honolulu, Hawaii, USA
  2. 2 Department of Medicine, Walter Reed Army Medical Center, Bethesda, Maryland, USA
  3. 3 Department of Gastroenterology, Tripler Army Medical Center, Honolulu, Hawaii, USA
  1. Correspondence to Dr Ki Suk Eum, Department of Medicine, Tripler Army Medical Center, Honolulu, HI 96859, USA; petereum86{at}gmail.com

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The patient is a 59-year-old woman with Goodpasture’s disease on immunosuppressants presenting with hemodynamically significant gastrointestinal bleeding (GIB) requiring blood product transfusion and intensive care unit admission. Initial colonoscopy was notable only for a few non-bleeding, superficial rectal ulcers and a large fecolith. One week thereafter, the patient developed haemorrhagic shock from another GIB, haemoglobin of 5.2 g/L and substantial bright red blood per rectum necessitating emergent blood product resuscitation.

Mesenteric arteriography revealed active extravasation in the rectum …

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