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Endoscopy 1997; 29(9): 834-839
DOI: 10.1055/s-2007-1004317
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Management of Dieulafoy Lesions of the Stomach: A Case Study of 26 Patients.

A. Parra-Blanco, H. Takahashi, P.V. Méndez Jerez, T. Kojima, K. Aksoz, K. Kirihara, J. Palmerín, Y. Takekuma, R. Fuijta
  • Showa University School of Medicine, Fujigaoka Hospital, Department of Internal Medicine, Division of Gastroenterology, Yokohama, Japan
Presented at the 7th Asian-Pacific Congress of Digestive Endoscopy, Japan, September 1996
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Publication Date:
17 March 2008 (online)

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Abstract

Background and Study Aims: We studied the clinical features and therapeutic outcome in patients with a diagnosis of Dieulafoy lesion.

Patients and Methods: Twenty-six patients who had upper gastrointestinal bleeding from Dieulafoy lesions received endoscopic therapy. The clinical and endoscopic features, and the outcome of therapy, were analysed retrospectively.

Results: Hemostasis was attempted by hemoclipping in 18 patients, heater probe in six patients and ethanol injection in two patients. The initial therapy was successful in 22 (84.6 %) cases. Hemostasis was achieved with additional endoscopic therapy in three cases (11,5 %). Surgical treatment was needed only in one case, owing to uncontrolled bleeding. One patient died during the hospital stay from a cause unrelated to the Dieulafoy lesion. There were no side effects related to endoscopic therapy. None of these patients presented with rebleeding from Dieulafoy lesions over a mean long-term follow-up of 36 months.

Conclusions: Bleeding from Dieulafoy lesions can be managed successfully by endoscopic methods, and these should be regarded as the first choice in their management. We emphasize the role of hemoclipping, a mechanical method, for the endoscopic treatment of these lesions.