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      Appendiceal bleeding: A case report

      case-report

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          Abstract

          BACKGROUND

          Acute lower gastrointestinal bleeding is common in clinical practice, and the colon is responsible for the majority of cases. However, appendiceal bleeding is an extremely rare cause. Appendiceal bleeding due to vascular diseases, such as angiodysplasia and Dieulafoy’s lesion, may result in massive lower gastrointestinal bleeding. Appendectomy is a reliable and effective option for treatment.

          CASE SUMMARY

          A 32-year-old male presented to our hospital with hematochezia that had lasted for 6 h, with approximately 600-800 mL bloody stools and loss of consciousness for a few seconds. Persistent bleeding from the orifice of the appendix was observed by colonoscopy. Following the new diagnosis of appendiceal bleeding, the patient was treated by an emergency laparoscopic appendectomy. Finally, the patient was pathologically diagnosed with appendiceal Dieulafoy’s lesion. The patient was uneventfully discharged, and follow-up 2 wk later showed no evidence of rebleeding.

          CONCLUSION

          Although appendiceal bleeding is a rare cause of acute lower gastrointestinal bleeding, clinicians should consider it during differential diagnosis.

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          Most cited references17

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          Angiodysplasia of the appendix.

          Angiodysplasia of the gastrointestinal tract is thought to be one of the most common causes of lower gastrointestinal bleeding in the elderly, and, in the majority of cases, lesions are located in the cecum or ascending colon. The authors report an extremely rare case of appendicular angiodysplasia. A 76-yr-old woman was hospitalized with massive recurrent red anal bleeding. Selective superior mesenteric arteriography revealed an extravasation of contrast material from the appendicular artery, and this finding proved to be bleeding from an angiodysplasia of the appendix. An appendectomy was performed, and anal bleeding did not recur postoperatively. A review of the literature revealed this to be an extremely rare case of angiodysplasia.
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            The management of lower gastrointestinal hemorrhage.

            Gastrointestinal hemorrhage is a common clinical problem, which accounts for approximately 1 to 2 percent of acute hospital admissions. The colon is responsible for approximately 87 to 95 percent of all cases of lower gastrointestinal bleeding, with the remaining cases arising in the small bowel. The etiology, diagnostic evaluation, management, and treatment options available for lower gastrointestinal hemorrhage were reviewed.
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              Dieulafoy's lesion of the oesophagus: a case series and literature review

              Dieulafoy's lesion is a vascular abnormality consisting of a tortuous, dilated aberrant submucosal vessel that erodes the overlying mucosal layer without ulceration. The oesophagus is a very rare location for the lesion. Herein, we report a case series of 3 patients who presented with upper gastrointestinal bleeding. Endoscopy was performed, which showed a large calibre-persistent tortuous submucosal artery protruding into the oesophageal lumen. All the patients were successfully managed with endoscopic intervention using epinephrine injection around the lesion followed by hemoclip application. The present paper highlights the remarkably rare occurrence of oesophageal Dieulafoy's lesion and reviews the pathophysiology, epidemiology and management with a focus on diagnostic challenge encountered in such patients.
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                Author and article information

                Contributors
                Journal
                World J Clin Cases
                WJCC
                World Journal of Clinical Cases
                Baishideng Publishing Group Inc
                2307-8960
                26 June 2022
                26 June 2022
                : 10
                : 18
                : 6314-6318
                Affiliations
                Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
                Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China
                Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China. yexiaohuare@ 123456qq.com
                Author notes

                Author contributions: Zhou SY designed and drafted the manuscript; Guo MD performed the colonoscopy; Ye XH revised the manuscript for important intellectual content; and all authors approved the final version of the manuscript.

                Supported by the Natural Science Foundation of Zhejiang Province, No. LQ19H030003; and Key Project of Jinhua Science and Technology Bureau, No. 2018A32022.

                Corresponding author: Xiao-Hua Ye, MD, Deputy Director, Department of Gastroenterology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua 321000, Zhejiang Province, China. yexiaohuare@ 123456qq.com

                Article
                jWJCC.v10.i18.pg6314
                10.12998/wjcc.v10.i18.6314
                9254187
                35949834
                76dc27d8-c700-456f-98e2-fbd056195f46
                ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

                History
                : 31 December 2021
                : 27 January 2021
                : 24 April 2022
                Categories
                Case Report

                appendix,gastrointestinal hematochezia,lower gastrointestinal tract,vascular malformations,case report

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