Endoscopic Doppler Probe in the Diagnosis and Management of Upper Gastrointestinal Hemorrhage

Abstract

Through-the-scope (TTS) endoscopic Doppler ultrasound probe technology is a tool that has garnered interest for the evaluation of variceal and non-variceal bleeding. In previous studies, this technology has been proposed as a more objective method of identifying the bleeding subsurface blood vessel in peptic ulcer hemorrhage. We describe 3 cases where the use of an endoscopic Doppler probe guided the diagnosis and management of upper gastrointestinal (GI) hemorrhage due to causes other than peptic ulcer disease. The first case describes a patient with a duodenal Dieulafoy lesion, while the other 2 cases outline patients with a gastroesophageal varix as the etiology of the bleed.

Management of non-variceal upper gastrointestinal bleeding: role of endoscopic ultrasound-guided treatments

“…There are two cases where EUS-guided coil/clip deployment combined with epinephrine injection was performed ( Table 7 ). In the case series of Satyavada et al , 22 EUS was used in the diagnosis and treatment of an obscure gastrointestinal bleeding which turned out due to Dieulafoy’s lesion. EUS-guided therapy was performed with the injection of 1:10,000 epinephrine and the deployment of four hemoclips.…”

“…A total of 20 articles were found, including 15 case reports and 5 case series. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The identifications of patients (including type of lesion, type of bleeding, and previous treatments), details of procedures (including specific type of treatment, type of needle), and main outcomes (including technical and clinical outcomes, and complications) for each study were reviewed. A total of 44 patients were induced and divided into different classifications according to the treatments.…”

Advancements in endoscopic hemostasis for non-variceal upper gastrointestinal bleeding

“…While the former is treated per current guidelines, the latter is traditionally not treated endoscopically[ 43 ]. Preliminary studies have also demonstrated the use of doppler probe for the diagnosis and treatment of gastric varices, Dieulafoy’s lesion, diverticular bleeding, and post-ESD ulcers[ 45 ].…”