Endoscopy 2004; 36(5): 416-420
DOI: 10.1055/s-2004-814322
Original Article
© Georg Thieme Verlag Stuttgart · New York

Dieulafoy’s Lesion: Management and Long-Term Outcome

J.  M.  Romãozinho1 , J.  M.  Pontes1 , C.  Lérias1 , M.  Ferreira1 , D.  Freitas1
  • 1Department of Gastroenterology, University Hospitals of Coimbra, Coimbra, Portugal
Further Information

Publication History

Submitted 17 March 2003

Accepted after Revision 9 November 2003

Publication Date:
21 April 2004 (online)

Background and Study Aims: Dieulafoy’s lesion is usually considered to be a rare cause of gastrointestinal bleeding and little information is available about the long-term follow-up of this condition. We studied the clinical pattern and long-term outcome in patients with Dieulafoy’s lesion who were managed in a gastrointestinal intensive care unit.
Patients and Methods: We reviewed the data on the diagnosis, treatment, and outcome of 70 patients admitted to our unit for acute upper gastrointestinal bleeding due to Dieulafoy’s lesion. Endoscopic hemostasis was performed in 69 cases. Patients underwent surgery if endoscopic therapy failed. A phone interview was carried out to assess the long-term clinical outcome.
Results: Dieulafoy’s lesion accounted for 4 % of cases of upper gastrointestinal bleeding in patients admitted during the period studied. The mean number ± SD of endoscopies required to establish the diagnosis was 1.4 ± 0.75. Endoscopic hemostasis was initially successful in 91.3 % of patients, while nearly 16 % of patients required surgery because endoscopic therapy failed. The overall mortality rate was 8.6 %. None of the 52 patients who were followed up by phone reported recurrent bleeding after discharge from hospital, in a mean follow-up period of 69 months.
Conclusions: Dieulafoy’s lesion is a not uncommon cause of severe recurrent gastrointestinal bleeding. Endoscopic therapy is safe and effective in achieving permanent hemostasis. The long-term prognosis for Dieulafoy’s lesion is excellent, even when patients are treated using endoscopic methods alone.

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J. M. Romãozinho

Department of Gastroenterology

University Hospitals of Coimbra · Praceta Prof. Mota Pinto · 3000-075 Coimbra · Portugal

Fax: +351-239-701517

Email: jmpontes@mail.telepac.pt

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