Endoscopic Band Ligation for Rectal Dieulafoy's Lesion: Serial Endoscopic Images

Figure 1 An 85-year-old Japanese woman with rectal Dieulafoy's lesion presented with fresh blood hematochezia. Colonoscopy revealed a 5 mm shallow mucosal defect with an exposed vessel in the anterior wall of the lower rectum.

Figure 2 A gastroduodenoscope with an attached single-band ligator was employed, and 4 ml of hypertonic saline epinephrine solution was injected beneath the lesion. After endoscopic band placement, the hemorrhage stopped completely. Note that the Dieulafoy's lesion had been wholly encased by the band.

Figure 3 Endoscopy at 1 week after the procedure revealed a 10 mm wide shallow ulcer at the site of the lesion. The O-ring remained on the ulcerated lesion.

Figure 4 Follow-up colonoscopy (at 2 weeks) showed an ulcer scarring. No further bleeding has occurred during 6 months of follow-up.