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The efficiency of endoclips in maintaining the gastrointestinal bleeding-related Dieulafoy’s lesion

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Summary

Background

Dieulafoy’s lesion (DL) is a relatively uncommon medical condition characterized by a large tortuous arteriole in the submucosa of any part of gastrointestinal (GI) tract wall that bleeds via erosion likely caused in the submucosal surface by protrusion of the pulsatile arteriole. Compared with other endoscopic hemostatic techniques, clipping alone for DL is limited.

Aims

The aim of the present case series study is to identify common clinical and endoscopic features, rates of occurrence, to review the outcome of endoscopic management of upper GI tract DL, and to illustrate the use and the efficiency of endoclips in maintaining the GI bleeding due to DL.

Patients and methods

This case series was conducted at Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital. The patients who were admitted to the emergency department of Dıskapı Yıldırım Beyazıt Educational and Research Hospital underwent gastrointestinal system (GIS) endoscopy between 2008 and 2013 and were assessed retrospectively. Five cases of GI bleeding related to DL were given endoscopic treatment with hemoclip application. Clinical data, endoscopic findings, and the effects of the therapy were evaluated.

Results

The median number of endoscopic hemoclips application in first endoscopy was 4 (2–9). Rebleeding developed in all patients who had hemoclips applied. Re-endoscopy was performed in three of these patients, which controlled the bleeding. Two patients were transferred to surgery.

Conclusions

Combination of endoscopic injection and mechanical therapies seems a suitable method for maintaining upper GIS bleeding due to DL. Also, further studies are needed to better define the best endoscopic approach for the treatment of DL.

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Acknowledgments

We hereby declare that all authors have made a substantial contribution to the information submitted for publication; all have read and approved the final manuscript and the manuscript or portions thereof are not under consideration by another journal.

Conflict of interest

We are stating that all the authors have no financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work. As a result, we have no conflict of interest to report.

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Authors and Affiliations

  1. Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey

    Fatih Karaahmet MD, Serta Kılıncalp MD, Yusuf Coskun MD, Mevlut Hamamci MD, Hakan Akinci MD, Yusuf Ustun MD, Zahide Simsek MD, Elife Erarslan MD, Sahin Coban MD & Ilhami Yuksel MD

  2. Department of Gastroenterology, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey

    Ilhami Yuksel MD

Authors
  1. Fatih Karaahmet MD
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  2. Serta Kılıncalp MD
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  3. Yusuf Coskun MD
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  4. Mevlut Hamamci MD
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  5. Hakan Akinci MD
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  6. Yusuf Ustun MD
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  7. Zahide Simsek MD
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  8. Elife Erarslan MD
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  9. Sahin Coban MD
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  10. Ilhami Yuksel MD
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Correspondence to Fatih Karaahmet MD.

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Karaahmet, F., Kılıncalp, S., Coskun, Y. et al. The efficiency of endoclips in maintaining the gastrointestinal bleeding-related Dieulafoy’s lesion. Wien Klin Wochenschr 128, 700–705 (2016). https://doi.org/10.1007/s00508-015-0739-1

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  • DOI: https://doi.org/10.1007/s00508-015-0739-1

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