Culprit for recurrent acute gastrointestinal massive bleeding: “Small bowel Dieulafoy’s lesions” - a case report and literature review

Sathyamurthy, Anjana; Winn, Jessica; Ibdah, Jamal A.; Tahan, Veysel

doi:10.4291/wjgp.v7.i3.296

Cited by 8 publications

(9 citation statements)

References 19 publications

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“…Band ligation, however, has been associated with a high risk of bowel perforation, especially in cases of small bowel and colon lesions 39. Besides endoscopy, angiography with gel-foam embolisation is another treatment modality that has been reported to be successful in some cases 40. On the other hand, surgical procedures are reserved for difficult-to-control bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, surgical procedures are reserved for difficult-to-control bleeding. However, surgery has a higher mortality rate as often times these patients may already be haemodynamically unstable by the time surgical intervention is considered 40. Therefore, a prompt and accurate diagnosis in patients with a Dieulafoy’s lesion carries paramount importance because massive, uncontrolled bleeding from this lesion may culminate in death of the patient fairly quickly.…”

Section: Discussionmentioning

confidence: 99%

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Dieulafoy’s lesion of the colon and rectum: a case series and literature review

Inayat

Ullah²,

Hussain³

et al. 2017

BMJ Case Reports

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Dieulafoy's lesion is a dilated, aberrant, submucosal vessel that erodes the overlying epithelium without obvious ulceration. It is most commonly located in the lesser curvature of the stomach but rare occurrences in extragastric sites have also been reported. Herein, we describe a case series of three patients who presented with lower gastrointestinal bleeding. Colonoscopy revealed a caliber-persistent tortuous submucosal artery protruding into the lumen of the colon or rectum. The patients were diagnosed with Dieulafoy's lesion and primary haemostasis was achieved with the endoscopic haemoclip application. The purpose of this review is to summarise the available data on the pathophysiology, epidemiology, clinical presentation, diagnosis and management of patients with Dieulafoy's lesion of the colon and rectum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dieulafoy’s lesion of the colon and rectum: a case series and literature review

Inayat

Ullah²,

Hussain³

et al. 2017

BMJ Case Reports

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“…2 This atypical lesion of undetermined etiology was subsequently termed as “Dieulafoy’s lesion.” Since then, the definition of this abnormality has been diversified to represent an acute process occurring in several body locations. 3 Currently, the true incidence remains unknown, but it is responsible for up to 5% of gastrointestinal bleeds. 4 -6 It shows a predilection toward advanced age, with a male-to-female ratio of 2:1.…”

Section: Introductionmentioning

confidence: 99%

Jejunal Dieulafoy’s Lesion: A Systematic Review of Evaluation, Diagnosis, and Management

Malik

Inayat

Goraya

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

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Jejunal Dieulafoy’s lesion is an exceedingly rare but important cause of gastrointestinal bleeding. It frequently presents as a diagnostic and therapeutic conundrum due to the rare occurrence, intermittent bleeding symptoms often requiring prompt clinical action, variability in the detection and treatment methods, and the risk of rebleeding. We performed a systematic literature search of MEDLINE, Cochrane, Embase, and Scopus databases regarding jejunal Dieulafoy’s lesio from inception till June 2020. A total of 136 cases were retrieved from 76 articles. The mean age was 55 ± 24 years, with 55% of cases reported in males. Patients commonly presented with melena (33%), obscure-overt gastrointestinal bleeding (29%), and hemodynamic compromise (20%). Hypertension (26%), prior gastrointestinal surgery (14%), and valvular heart disease (13%) were the major underlying disorders. Conventional endoscopy often failed but single- and double-balloon enteroscopy identified the lesion in 96% and 98% of patients, respectively. There was no consensus on the treatment. Endoscopic therapy was instituted in 64% of patients. Combination therapy (34%) with two or more endoscopic modalities, was the preferred approach. With regard to endoscopic monotherapy, hemoclipping (19%) and argon plasma coagulation (4%) were frequently employed procedures. Furthermore, direct surgical intervention in 32% and angiographic embolization was performed in 4% of patients. The rebleeding rate was 13.4%, with a mean follow-up duration of 17.6 ± 21.98 months. The overall mortality rate was 4.4%. Jejunal Dieulafoy’s lesion is still difficult to diagnose and manage. Although the standard diagnostic and therapeutic modalities remain to be determined, device-assisted enteroscopy might yield promising outcomes.

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“…This technique is a standard method to control varix bleeding in cirrhotic patients worldwide [ 28 , 29 ]. However, there has been no clinical evaluation of its effectiveness in treating duodenal DL, except for a recent case report [ 30 ]. In the present study, we retrospectively analyzed the effectiveness of cyanoacrylate injection versus hemoclip placement in duodenal DL treatment.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Cyanoacrylate Injection versus Hemoclip Placement for Bleeding Dieulafoy’s Lesion in Duodenum

Jiang

et al. 2018

Gastroenterology Research and Practice

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Background Duodenal Dieulafoy's lesion (DL) is a rare disease that may lead to lethal hemorrhage in the upper gastrointestinal tract. The best technique for endoscopic intervention still remains unclear. In the present study, we performed a retrospective analysis of cyanoacrylate injection versus hemoclip placement for treating bleeding DLs. Materials and Methods We retrospectively analyzed eighteen patients from three medical centers between October 2008 and February 2016; six patients received cyanoacrylate injection, while hemoclips were placed in 12 patients during the upper gastrointestinal endoscopy. Results All patients received first endoscopic examination and/or endotherapy within 12 hours of admission to hospital. No difference was observed in the primary hemostasis rate or the recurrent hemorrhage rate between the cyanoacrylate injection (CI) group and the hemoclip placement (HP) group, except that in one patient from the HP group melena was found three days after the first endotherapy. This patient received cyanoacrylate injection once again. Conclusion Both cyanoacrylate injection and hemoclip placement are effective in treating duodenal DL, and neither of them causes significant side effects.

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Culprit for recurrent acute gastrointestinal massive bleeding: “Small bowel Dieulafoy’s lesions” - a case report and literature review

Cited by 8 publications

References 19 publications

Dieulafoy’s lesion of the colon and rectum: a case series and literature review

Dieulafoy’s lesion of the colon and rectum: a case series and literature review

Jejunal Dieulafoy’s Lesion: A Systematic Review of Evaluation, Diagnosis, and Management

A Retrospective Analysis of Cyanoacrylate Injection versus Hemoclip Placement for Bleeding Dieulafoy’s Lesion in Duodenum

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