Clinical Feature and the Effects of Endoscopic Band Ligation of Dieulafoy-like Lesion

Jeong, Eul Jo; Bae, Yong Mock; Kim, Kwang Ha; Heo, Jeong; Heo, Jeong Ho; Chu, Hyung Jun; Kang, Dae Hwan; Song, Geun Am; Cho, Mong; Yang, Ung Suk

Abstract

BACKGROUND/AIMS: The Dieulafoy lesion is an important cause of gastrointestinal bleeding. The bleedings from caliber- persistent vessel or abnormally large and tortuous submucosal artery are usually located on proximal stomach. Endoscopic band ligation (EBL) is currently regarded as the treatment of choice of Dieulafoy lesions. This study reports on the clinical features, the efficacy and safety of EBL.
METHODS
10 patients with Dieulafoy-like lesion (median age: 47 yr range: 22~71, M:F 8:2 ) were treated using EBL. EBL was performed as the primary hemostatic tratment as follows in 8 cases of urgency and 2 cases of emergency.
RESULTS
The location of all lesions (n=10) were in stomach, 8 in body (4 in posterior wall), 2 in fundus. The bleeding focuses were identified during the first endoscopy. Five lesions were bleeding, 5 had adherent clots or protruding vessels without active bleeding. Hemostasis were achieved with first session of EBL in 9 patients successfully, one case in the fundus was failed due to early band release.
CONCLUSION
EBL is a simple, effective, and safe endoscopic method of Dieulafoy-like lesions and, it should be proposed as a primary option.