Dieulafoy's Lesion: The Role of Endoscopic Ultrasonography as a Roadmap

Barosa, Rita; Pires, Sara; Pinto-Marques, Pedro; Pereira, José António; Bilhim, Tiago

doi:10.1159/000450902

Cited by 5 publications

(3 citation statements)

References 4 publications

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“…Furthermore, push enteroscopy and capsule endoscopy have their limitations as well. Therefore, it is important to suspect a Dieulafoy’s lesion in all patients with no clear source of gastrointestinal bleed and an endoscopic ultrasonography should be considered to confirm the diagnosis in the equivocal cases 32. Other radiological techniques including contrast-enhanced CT or mesenteric angiography are also helpful, especially when the initial endoscopy is unable to provide a definitive diagnosis 33 34.…”

Section: Discussionmentioning

confidence: 99%

Dieulafoy’s lesion of the colon and rectum: a case series and literature review

Inayat

Ullah²,

Hussain³

et al. 2017

BMJ Case Reports

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Dieulafoy's lesion is a dilated, aberrant, submucosal vessel that erodes the overlying epithelium without obvious ulceration. It is most commonly located in the lesser curvature of the stomach but rare occurrences in extragastric sites have also been reported. Herein, we describe a case series of three patients who presented with lower gastrointestinal bleeding. Colonoscopy revealed a caliber-persistent tortuous submucosal artery protruding into the lumen of the colon or rectum. The patients were diagnosed with Dieulafoy's lesion and primary haemostasis was achieved with the endoscopic haemoclip application. The purpose of this review is to summarise the available data on the pathophysiology, epidemiology, clinical presentation, diagnosis and management of patients with Dieulafoy's lesion of the colon and rectum.

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Section: Discussionmentioning

confidence: 99%

Dieulafoy’s lesion of the colon and rectum: a case series and literature review

Inayat

Ullah²,

Hussain³

et al. 2017

BMJ Case Reports

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show abstract

“…For patients with severe or obscure GI bleeding, EUS has been shown to aid in both identifying the location of the offending vessel as well as confirming that the bleeding vessel has been effectively treated. Dieulafoy lesions are arterial malformations that are extremely elusive because of their submucosal location, but EUS can identify them below the surface with ultrasound and Doppler ( 143 ). Once found, submucosal vascular malformations can be treated using conventional hemostatic methods with the aid of EUS to confirm vessel obliteration.…”

Section: Advances In Pediatric Diagnostic Endoscopymentioning

confidence: 99%

Advances in Pediatric Diagnostic Endoscopy: A State-of-the-Art Review

et al. 2022

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Pediatric endoscopy has revolutionized the way we diagnose and treat gastrointestinal disorders in children. Technological advances in computer processing and imaging continue to affect endoscopic equipment and advance diagnostic tools for pediatric endoscopy. Although commonly used by adult gastroenterologists, modalities, such as endomicroscopy, image-enhanced endoscopy, and impedance planimetry, are not routinely used in pediatric gastroenterology. This state-of-the-art review describes advances in diagnostic modalities, including image-enhanced endoscopy, confocal laser endomicroscopy, optical coherence tomography, endo functional luminal imaging probes, wireless motility/pH capsule, wireless colon capsule endoscopy, endoscopic ultrasound, and discusses the basic principles of each technology, including adult indications and pediatric applications, safety cost, and training data.

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“…In this paper, the authors used two images previously published in a snapshot in GE Portuguese Journal of Gastroenterology [19]. The EUS images were obtained by the same echoendoscopist in our center.…”

Section: Conflict Of Interest Statementmentioning

confidence: 99%

A Unique Case of Recurrent Upper Gastrointestinal Bleeding Caused by Two Metachronous Dieulafoy’s Lesions: The Role of EUS Evaluation

Brito

Nunes

Pinto-Marques

et al. 2020

GE Port J Gastroenterol

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Introduction: Dieulafoy’s lesion (DL) is a rare but important cause of acute, severe, life-threatening, and recurrent upper gastrointestinal bleeding (UGIB). It is frequently difficult to diagnose DL with upper GI endoscopy (UGIE), and endoscopic ultrasonography (EUS) may be valuable. There are only 2 reported bleeding cases caused by two synchronous DL but no reported cases of two metachronous DL. Case Report: A 28-year-old healthy male presented with acute severe UGIB. UGIE was inconclusive. Systematic EUS mapping identified a gastric DL. After several attempts of EUS-guided hemostasis, DL was marked using a through-the-scope clip and the patient underwent successful transcatheter arterial embolization (TAE). Three years later, a new severe UGIB episode was caused by a second gastric DL in a different location, which was identified and marked by EUS and further successfully treated through TAE. The patient maintained follow-up without evidence of further bleeding. Discussion/Conclusion: The authors report a unique case of severe, recurrent UGIB caused by two metachronous gastric DL lesions. The importance of systematic EUS scanning for diagnosis, treatment, and follow-up of DL is emphasized, as well as the potential influence in the outcome of other techniques like angiographic embolization.

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Dieulafoy's Lesion: The Role of Endoscopic Ultrasonography as a Roadmap

Cited by 5 publications

References 4 publications

Dieulafoy’s lesion of the colon and rectum: a case series and literature review

Dieulafoy’s lesion of the colon and rectum: a case series and literature review

Advances in Pediatric Diagnostic Endoscopy: A State-of-the-Art Review

A Unique Case of Recurrent Upper Gastrointestinal Bleeding Caused by Two Metachronous Dieulafoy’s Lesions: The Role of EUS Evaluation

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