Endoscopic management of Dieulafoy lesions of the stomach: A case study of 26 patients

Background and Study Aims: We studied the clinical features and therapeutic outcome in patients with a diagnosis of Dieulafoy lesion. Patients and Methods: Twenty-six patients who had upper gastrointestinal bleeding from Dieulafoy lesions received endoscopic therapy. The clinical and endoscopic features, and the outcome of therapy, were analysed retrospectively. Results: Hemostasis was attempted by hemoclipping in 18 patients, heater probe in six patients and ethanol injection in two patients. The initial therapy was successful in 22 (84.6%) cases. Hemostasis was achieved with additional endoscopic therapy in three cases (11,5%). Surgical treatment was needed only in one case, owing to uncontrolled bleeding. One patient died during the hospital stay from a clause unrelated to the Dieulafoy lesion. There were no side effects related to endoscopic therapy None of these patients presented with rebleeding from Dieulafoy lesions over a mean long-term follow-up of 36 months. Conclusions: Bleeding from Dieulafoy lesions can be managed successfully by endoscopic methods, and these should be regarded as the first choice in their management. We emphasize the role of hemoclipping, a mechanical method, for the endoscopic treatment of these lesions.