Dieulafoy Lesions of the GI Tract: Localization and Therapeutic Outcomes

Lara, Luis F.; Sreenarasimhaiah, Jayaprakash; Tang, Shou Jiang; Afonso, Bianca; Rockey, Don C.

doi:10.1007/s10620-010-1385-0

Cited by 73 publications

(62 citation statements)

References 25 publications

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“…The amount of bleeding ranges from mild self-limiting episodes to the life-threatening recurrent and profuse bleeding. Patients with the comorbidities such as hypertension, chronic kidney disease, alcoholism, cardiovascular disease and diabetes are relatively at a higher risk to bleed 14. Interestingly, a significant portion of bleeding occurs in patients hospitalised for other causes pointing towards physiological stress as an inciting factor for arterial perforation 9.…”

Section: Discussionmentioning

confidence: 99%

Dieulafoy's lesion of the oesophagus: a case series and literature review

Inayat

Ullah²,

Hussain

et al. 2017

BMJ Case Reports

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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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Section: Discussionmentioning

confidence: 99%

Dieulafoy's lesion of the oesophagus: a case series and literature review

Inayat

Ullah²,

Hussain

et al. 2017

BMJ Case Reports

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show abstract

“…DL in the stomach is most commonly observed. However, it may occur in other regions including the jejunum, colon, rectum or even gallbladder . According to a systematic study, DL in the small bowel is a potential source of obscure GI bleeding, with an incidence of 3.5%, and most of these lesions are located in the proximal jejunum …”

mentioning

confidence: 92%

Gastroscopy: Advancing further into the horizontal part of the duodenum

Qiao

Ren

Liu

et al. 2017

J of Digest Diseases

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“…The diagnosis of DL is usually made by endoscopy, the endoscopic diagnostic rate of the lesion being over 90% of the cases [15,16]. Often, diagnosis may be difficult especially during the initial episode of hemorrhage due both to the small size of the lesion and the intermittent nature of the bleeding therefore a lot of patients require multiple endoscopic examinations for accurate diagnosis [6,17].…”

Section: Introductionmentioning

confidence: 99%

Clinical Features, Endoscopic Management and Outcome of Patients with Non-variceal Upper Digestive Bleeding by Dieulafoy Lesion

Goldiş¹,

Lupușoru²,

Lazăr³

2017

Biol Med

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Abstract:Aim and background: Dieulafoy lesion (DL) represents a rare, but important cause of major upper digestive bleeding, especially in elders. The aim of the study consists in identifying the clinico-biological and endoscopic features and the outcome of these patients. Methods:We retrospectively evaluated the patients admitted with non-variceal upper digestive bleeding (UDB) in the Department of Gastroenterology, of the Emergency County Hospital Timisoara, from 2003 to 2014. Out of the total number of cases we selected the patients with endoscopic diagnosis of Dieulafoy lesion. In these patients we analyzed the demographic, clinico-biological and endoscopic data, compared to the control group that encountered the rest of the patients with UDB. Results:Out of 2104 patients with non-variceal UDB, 31/2104 (1.5%) presented DL, 19/31(61.3%) male and 12/31(38.7%) female, mean age 63 ± 12.83. Diabetes mellitus was present in 35.5% cases. The mean value of hemoglobin was significantly lower in Dieulafoy group 7 ± 2.69 vs. 8 ± 3.28 in the control group, p=0.05, thus a significantly larger number of blood units per patient were needed in this group (p<0.0001). Re-bleebing was encountered significantly more often in Dieulafoy vs. control group: 7/31(22.6%) vs. 173/2074 (8.34%), p=0.03; surgery was needed in 3/31(9.7%) Dieulafoy patients. Endoscopic haemostasis was achieved most frequently by using combined treatment. The use of anticoagulants had a significant influence in the development of DL (p=0.019).Conclusion: DL may cause massive bleeding and is associated with a high rate of re-bleeding. Patients present comorbidities, diabetes mellitus being mostly associated with this condition. Anticoagulants represent risk factors highly associated with DL.

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Dieulafoy Lesions of the GI Tract: Localization and Therapeutic Outcomes

Cited by 73 publications

References 25 publications

Dieulafoy's lesion of the oesophagus: a case series and literature review

Dieulafoy's lesion of the oesophagus: a case series and literature review

Gastroscopy: Advancing further into the horizontal part of the duodenum

Clinical Features, Endoscopic Management and Outcome of Patients with Non-variceal Upper Digestive Bleeding by Dieulafoy Lesion

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