Management and long-term prognosis of Dieulafoy lesion

Role of endoscopic band ligation in management of non-variceal upper gastrointestinal bleeding

“…Surgical therapy is reported to be required in only 4%-8% of patients with DL. [10][11][12] It has been shown that EBL and haemoclip are equally effective and safe for the treatment of active bleeding in MWTs 12 and DL. 4 Postpolypectomy haemorrhage occurs in 0.5%-2.2% of cases of endoscopic polypectomy and may be delayed.…”

Upper Gastrointestinal Haemorrhage

“…1 Various endoscopic haemostatic methods have been advocated but most experience has been with thermal ablation (heater probe), which should be available in most centres. Long term recurrence was not evident after successful endoscopic ablation.…”

“…Long term recurrence was not evident after successful endoscopic ablation. 1 A recent study advocates endoscopic haemoclip application as an alternative effective and safe method with long term benefits. 2 Our patient was initially treated with an injection of epinephrine to slow down the bleeding rate followed by thermal ablation to achieve haemostasis (fig 1 below).…”

“…Dieulafoy's lesion is an important cause of upper gastrointestinal haemorrhage and may account for up to 5% of acute haemorrhages. 1 Dieulafoy et al described it in 1897 as exulceratio simplex, cirsoid aneurysm. 1 The histological appearance is characteristic; a relatively large calibre artery that lies close to the mucosal surface, likely as a congenital anomaly.…”

“…1 Dieulafoy et al described it in 1897 as exulceratio simplex, cirsoid aneurysm. 1 The histological appearance is characteristic; a relatively large calibre artery that lies close to the mucosal surface, likely as a congenital anomaly. Most Dieulafoy lesions are diagnosed by their endoscopic features.…”