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Dieulafoy's lesion: a case series study
R S Walmsley1, Yuk-Tong Lee, Joseph J Y Sung
1Department of Gastroenterology, North Shore Hospital, Shakespeare Road, Private Bag 93-503, Takapuna, Auckland, New Zealand. russell.walmsley@waitematadhb.govt.nz
World Journal of Gastroenterology
|June 18, 2005
Summary
Dieulafoy's lesions (DL) cause significant upper gastrointestinal bleeding. Endoscopic treatment is highly successful, but high patient mortality persists due to comorbidities and age.
Area of Science:
- Gastroenterology
- Endoscopy
- Surgical Oncology
Background:
- Dieulafoy's lesions (DL) represent a rare but significant cause of acute upper gastrointestinal bleeding (GIB).
- Despite advances in endoscopic therapy, DL carries a high mortality rate, approaching 20%.
Purpose of the Study:
- To report the clinical experience and treatment outcomes of Dieulafoy's lesions.
- To analyze patient characteristics, treatment modalities, and success rates for DL.
Main Methods:
- A retrospective case study analyzed 36 patients with DL between 1993 and 2003.
- Patient data included demographics, comorbidities, lesion location, treatment methods, and 30-day mortality.
Main Results:
- 35 DL were identified in 33 patients; median age was 67 years, with a 5.6:1 male to female ratio.
- Endoscopic hemostasis was achieved in 88% of cases during the initial endoscopy using adrenaline injection or heater probe.
- Four cases of re-bleeding occurred, all successfully managed endoscopically. The 30-day mortality rate was 23%.
Conclusions:
- Endoscopic hemostasis is highly effective for Dieulafoy's lesions, achieving a 100% success rate in this series.
- High overall mortality in DL patients is primarily attributed to advanced age and significant comorbidities.