Dieulafoy's lesion: a case series study

• Published in: World journal of gastroenterology : WJG 2005-06, Vol.11 (23), p.3574-3577
• Main Authors: Walmsley, R S, Lee, Yuk-Tong, Sung, Joseph J Y
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Brief Reports; Female; Gastrointestinal Hemorrhage - epidemiology; Gastrointestinal Hemorrhage - surgery; Gastrointestinal Hemorrhage - therapy; Humans; Male; Medical Records; Middle Aged; Registries; Retrospective Studies; Surgical Instruments; Treatment Outcome
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v11.i23.3574

Dieulafoy's lesion (DL) accounts for 1-5.8% of cases of acute upper gastrointestinal bleeding (GIB). Its mortality is high, approaching 20%, despite recent advances in endoscopic therapy. We aimed to report our experience in the treatment of DL. A retrospective case study of all patients with DL between January 1993 and January 2003 was done. Characteristics, treatment methods, success rates and 30-d mortality of the patients were analyzed. Thirty-six patients were noted to have DL in the study period. Thirty-three records were available for assessment in which 35 DL were identified. The median age of the patients was 67 years with male to female ratio of 5.6:1. Significant comorbidities existed in 69% of the patients. Eighty-nine percent of the DL was found at first endoscopy, three DL at laparotomy. Significant coexistent endoscopic findings existed in 23%. Hemostasis was achieved in 88% by using adrenaline injection, or in combination with heater probe application at first endoscopy. Four cases had re-bleeding, all were successfully treated endoscopically. The 30-d mortality rate was 23%. Successful endoscopic hemostasis could be achieved in 100% of cases of DL. The overall mortality may still remain high, mainly due to the comorbidities and age of these patients.