Dieulafoy's Lesion: Pathology, Diagnosis and Treatment

Authors

  • Sunthorn Treesaranuwattana Department of Surgery, St. Mary Hospital, Nakhon Ratchasima, Thailand 30000
  • Choosak Khemtai Division of Emergency, St. Mary Hospital, Nakhon Ratchasima, Thailand 30000

Abstract

Background: Dieulafoy's lesion is un common cause of a cute gastrointestinal bleeding which is potentially life threatening if unrecognized. It may be overlooked during endoscopy or even laparotomy. Understanding of this pathology will improve the diagnostic accuracy and selection of effective hemostatic procedure.

Methods: Data were reviewed from published literature searching Medline database and reference lists of relevant major articles. Figures were collected from authors experience.

Results: About 341 cases of Dieulafoy's lesion of gastrointestinal tract have been reported in English literature up to year 2001. In the early reports most of them were gastric lesion and surgery was the mainstay for treatment and diagnosis with high mortality. After the advent of flexible endoscope, much increase of reported cases included extragastric Dieulafoy's lesions. Currently, therapeutic endoscopy is the treatment of choice while surgery is indicated when endoscopy fails to arrest the bleeding or is inaccessible or unavailable.

Conclusion: Dieulafoy's lesion is underdiagnosed rather than a rare disease. Endoscopy is the essential diagnostic procedure and therapeutic endoscopy is safe and effective for permanent hemostasis. Surgical treatment is required in about 5 per cent of cases.

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Published

2002-09-30

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Treesaranuwattana S, Khemtai C. Dieulafoy’s Lesion: Pathology, Diagnosis and Treatment. Thai J Surg [Internet]. 2002 Sep. 30 [cited 2022 Nov. 30];23(3):87-96. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/243072

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