#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

A gastric Dieulafoy’s lesion


Authors: Nehajová T.
Authors‘ workplace: Interní oddělení a Gastroenterologické centrum, Nemocnice Třinec, p.  o.
Published in: Gastroent Hepatol 2019; 73(2): 149-153
Category:
doi: https://doi.org/10.14735/amgh2019149

Overview

A Dieulafoy’s lesion is a rare cause of bleeding from the gastrointestinal tract (GIT). It is a vascular lesion characterized by an abnormally tortuous and caliber-persistent artery in the submucosa, which can be a source of massive life-threatening bleeding. Dieulafoy’s lesions most commonly develop in the stomach; however, bleeding from such lesions has been reported throughout the GIT. Men are twice as likely to be diagnosed with a Dieulafoy’s lesion as women, especially if they suffer from polymorbidity. This most commonly presents as hematemesis and melena. Endoscopy is the method of choice for diagnosis and therapy. Thermal, mechanical, and injection techniques are the most effective means to stop the bleeding. The rate of recurrent bleeding is significantly lower with combination therapy than with monotherapy. If endoscopic methods fail, angiography (both diagnostic and therapeutic) can be performed. Surgical intervention is currently reserved for cases where therapeutic endoscopy and angiography have failed. Mortality of patients with Dieulafoy’s lesions has significantly decreased due to progress in endoscopy. This case report presents a young and healthy man with recurrent gastrointestinal bleeding caused by a gastric Dieulafoy’s lesion. Endoscopic treatment followed by vascular intervention led to closure of the aberrant vessel without recurrence of bleeding.

 Conflict of Interest: Author declares that the article/manuscript complies with ethical standards, patient anonymity has been respected, and states that she has no financial, advisory or other commercial interests in relation to the subject matter.

Publication Ethics: The article/manuscript has not been published or is currently being submitted to another review.

The author agrees to publish her name and e-mail in the published article/manuscript.

Dedication: The article/manuscript is not supported by a grant nor has it been created with the support of any company.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted: 17. 1. 2019

Accepted: 12. 2. 2019

Keywords:

Dieulafoy’s lesion – gastrointestinal bleeding – therapeutic endoscopy


Sources

1. Maceček J, Staňka B, Šťastný J. Protézoduodenální píštěl – příčina masivního krvácení do gastrointestinálního traktu. Gastroent Hepatol 2017; 71 (4): 310–314. doi: 10.14735/amgh2017310.

2. Procházka V. Akutní endoskopie a nevarikózní krvácení do horní části gastrointestinálního traktu. Endoskopie 2012; 21 (1): 24–27.

3. Clements J, Clements B, Loughrey M. Gastric Dieulafoy lesion: a rare cause of massive haematemesis in an elderly woman. BMJ 2018. doi: 10.1136/bcr-201-223615.

4. Eddi R, Shah N, Depasquale JR. Gastrointestinal bleeding due to a Dieaulafoy lesion in the afferent limb of a Billroth II reconstruction. Gastroenterol Hepatol (NY) 2011; 7 (4): 268–271.

5. Nojkov B, Cappell MS. Gastrointestinal bleeding from Dieulafoy’s lesion: clinical presentation, endoscopic findings, and endoscopic therapy. World J Gastrointest Endosc 2015; 7 (4): 295–307. doi: 10.4253/wjge.v7.i4.295.

6. Baettig B, Haecki W, Lammer F et al. Dieulafoyś disease: endoskopic treatment and follow up. Gut 1993; 34 (10): 1418–1421.

7. Hanousek M, Fojtík P, Falt P et al. Endoskopické ošetření Dieulafoy léze v jejunu. 33. český a slovenský gastroenterologický kongres, Praha. [online]. Dostupné z: https: //www.cgs-cls.cz/wp-content/uploads/2016/02/01__m_hanousek_p_fal.pdf.

8. Eltawansy SA, Thyagarajan B, Baig N. Dieulafoy’s lesion in the ascending colon presenting with gastrointestinal bleeding and severe anemia complicated by a coexisting severe resistant chronic idiopathic thrombocytopenic purpura. Case Rep Gastrointest Med 2014; 2014: 203678. doi: 10.1155/2014/203678.

9. Baxter M, Aly EH. Dieulafoy‘s lesion: current trends in diagnosis and management. Ann R Coll Surg Engl 2010; 92 (7): 548–554. doi: 10.1308/003588410X12699663905311.

10. Jeon HK, Kim GH. Endoscopic management of Dieulafoy’s lesion. Clin Endosc 2015; 48 (2): 112–120. doi: 10.5946/ce.2015.48.2.112.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#