Lower Gastrointestinal Bleeding Due to Dieulafoy Lesion in Transverse Colon in an Adolescent: A Case Report

Background: Dieulafoy lesion (DL) is a rare gastrointestinal (GI) vascular anomaly characterized by the presence of a large-caliber submucosal artery, which can cause severe, recurrent hemorrhage when ruptured. Clinical Description: A 15-year-old boy with a known history of essential hypertension and obesity presented with acute-onset, recurrent bloody stools, associated with profound anemia. Cardiorespiratory and abdominal examination was normal. Management and Outcome: Baseline routine laboratory parameters, including coagulation profile, were normal, except anemia. Meckel’s scan revealed a suspicious marker in mid abdomen. Upper and lower GI endoscopy, video capsule endoscopy, including biopsies, diagnostic abdominal laparoscopy, and computed tomography angiography of the abdomen and pelvis did not reveal the source of bleeding. The patient was discharged after supportive treatment, only to be re-admitted for recurrence. Emergency colonoscopy, this time, revealed a well-defined DL in the transverse colon. The lesion was treated with epinephrine injection and thermocoagulation. Patient improved, and no recurrence of bloody stools was noted at follow-up. Conclusion: Dieulafoy lesion is a rare condition and often overlooked as a cause of GI tract bleeding in children, which may require multiple endoscopies for visualization.