Korean J Intern Med.  2009 Dec;24(4):318-322. 10.3904/kjim.2009.24.4.318.

Endoscopic Treatment of Dieulafoy Lesions and Risk Factors for Rebleeding

• Lim W
• Kim TO
• Park SB
• Rhee HR
• Park JH
• Bae JH
• Jung HR
• Kim MR
• Lee N
• Lee SM
• Kim GH
• Heo J
• Song GA

• KMID: 1776659
• DOI: http://doi.org/10.3904/kjim.2009.24.4.318

Abstract

BACKGROUND/AIMS
Dieulafoy lesions are an important cause of upper gastrointestinal bleeding. The purpose of this study was to assess the efficacy of endoscopic treatment for these lesions and to identify the possible predictive factors for rebleeding associated with clinical and endoscopic characteristics. METHODS: Records from 44 patients admitted with Dieulafoy bleeding between January 2006 and December 2007 were reviewed. We retrospectively analyzed the clinical and endoscopic findings and then correlated the rebleeding risk factors with Dieulafoy lesions. RESULTS: Primary hemostasis was achieved by endoscopic treatment in 39 patients (88.6%). There were no significant differences between the rebleeding and non-rebleeding groups with respect to age, gender, initial hemoglobin levels, presence of shock, concurrent disease, location of bleeding, or initial hemostatic treatment methods. However, the use of non-steroidal anti-inflammatory drugs or anticoagulants (p=0.02) and active stages in the Forrest classification (p<0.01) were risk factors for rebleeding after endoscopic therapy. CONCLUSIONS: Endoscopic therapy is effective and safe for treating Dieulafoy lesions, and it has both short- and long-term benefits. Early identification of risk factors such as the use of non-steroidal anti-inflammatory drugs or anticoagulants and the Forrest classification of bleeding predict the outcome of Dieulafoy lesions.

Keyword

Dieulafoy; Gastrointestinal hemorrhage; Endoscopy; Hemostasis; Anticoagulants

MeSH Terms

Adult
Aged
Arteriovenous Malformations/complications/*therapy
Female
Gastrointestinal Hemorrhage/etiology/*therapy
Hemostasis, Endoscopic/*methods
Humans
Male
Middle Aged
Recurrence
Risk Factors