Heparin provocation for identification and treatment of a gastric Dieulafoy's lesion

Wright, Curtis A.; Petersen, Bret T.; Bridges, Claude M; Alexander, Jeffrey A.

doi:10.1016/s0016-5107(04)00161-0

Cited by 14 publications

(6 citation statements)

References 15 publications

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“…The observation that anti‐thrombotic therapy might be able to reveal sites of gastrointestinal bleeding that remained obscure while coagulation was not impaired is not new. The deliberate use of anti‐thrombotic therapy during endoscopy to provoke gastrointestinal bleeding in order to find a source for OGIB has been described in several case reports 23–25 . Additionally, tissue plasminogen activator and heparin have been successfully used to provoke gastrointestinal bleeding during angiography in larger series of patients with recurrent OGIB 26,27 …”

Section: Discussionmentioning

confidence: 99%

Video capsule endoscopy for previous overt obscure gastrointestinal bleeding in patients using anti‐thrombotic drugs

Weyenberg

Turenhout

Jacobs

et al. 2011

Digestive Endoscopy

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Section: Discussionmentioning

confidence: 99%

Video capsule endoscopy for previous overt obscure gastrointestinal bleeding in patients using anti‐thrombotic drugs

Weyenberg

Turenhout

Jacobs

et al. 2011

Digestive Endoscopy

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“…10 In the latter situation, aids to endoscopic diagnosis have been suggested. Wright et al 26 have described provocation of bleeding using intravenous bolus of heparin. The use of endoscopic ultrasound has also been used to aid endoscopic diagnosis.…”

Section: Investigations Endoscopymentioning

confidence: 99%

Dieulafoy's lesion: current trends in diagnosis and management

Baxter

Aly

2010

annals

299

372

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Ann R Coll Surg Engl 2010; 92: 548-554 548The incidence of acute gastrointestinal bleeding ranges from 50-150 per 100,000 of the population each year. It is caused by peptic ulcers and oesophageal or gastroduodenal erosions in almost 80% of patients.1 Obscure gastrointestinal bleeding is reported to account for up to 5% of all gastrointestinal (GI) haemorrhages. It is defined as overt or occult bleeding from a source that cannot be readily determined by standard investigations, such as barium studies and endoscopic investigation. The source is often difficult to locate because the pathology is anatomically inaccessible, small, or subtle. Dieulafoy's lesion is one of the causes of obscure gastrointestinal bleeding that could result in treacherous and life-threatening gastrointestinal haemorrhage. 2,3A Dieulafoy's lesion, also termed 'calibre persistent artery', 2 is a relatively rare, but potentially life-threatening, cause of haemorrhage from the gastrointestinal tract. It is difficult to determine its true incidence in the general population accurately as they are silent until presentation and, even then, it can pose a diagnostic challenge. They are believed to account for only 1-2% of acute GI bleeding, [3][4][5] but are arguably under-recognised rather than being truly rare. The lack of awareness about the Dieulafoy's lesion contributes to its 'rarity', increase in morbidity, and also the previously reported mortality of up to 80% associated with this lesion.6 Rare or not, the precarious nature of the presentation make it necessary to include them in differential diagnosis of any acute GI haemorrhage. The aim of this article is to present an up-to-date review of literature on Dieulafoy's lesion and the recent trends in its diagnosis, treatment and prognosis. Materials and MethodsUsing Medline, a literature search was performed for papers published in English, using the text words 'Dieulafoy'(s)' and 'gastrointestinal bleeding'. All retrieved papers which were relevant to the study were analysed and the findings are summarised in this review. Overall, 159 Dieulafoy's lesion: current trends in diagnosis and management M Baxter, EH AlyLaparoscopic Colorectal Surgery and Training Unit, Aberdeen Royal Infirmary, Aberdeen, UK ABSTRACT BACKGROUND Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2% of acute gastrointestinal (GI) bleeding, but arguably is under-recognised rather than rare. Its serious nature makes it necessary to include it in the differential diagnosis of obscure GI bleeding. The aim of this study was to review the current trends in the diagnosis and management of Dieulafoy's lesion. MATERIALS AND METHODS Using Medline, a literature search was performed for articles published in English, using the search words 'Dieulafoy'(s)' and 'gastrointestinal bleeding'. All retrieved papers were analysed and the findings are summarised in this review. RESULTS There is no consensus on the treatment of Dieulafoy's lesions. Therapeutic endoscopy can control t...

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“…Bununla beraber literatürde tanısal amaçlı heparinle provake edilerek lezyonun yeri saptanıp tedavi edilen olgular bulunmaktadır. 12 Endoskopi alanındaki gelişmelerle birlikte Dieulafoy lezyonunun tanı ve tedavisinde önemli değişiklikler olmuştur. Tanı, en az 0,5 mL/dk aktif kanama varlığında yapılan endoskopilerin %71'inde konulabilmektedir.…”

Section: Discussionunclassified

A Rare Etiology of Massive Gastrointestinal Bleeding: Dieulafoy Lesion

Akyıldız¹,

Tekerek²,

Arslan³

et al. 2016

cayd

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Dieulafoy lezyonu çevresindeki gastrointestinal sistem mukozasının normal olduğu çok küçük yüzeyel bir ülser tabanında submukozaya açılan arteriyol ile karakterizedir. Lezyon nispeten nadir görülmekle beraber potansiyel olarak yaşamı tehdit eden bir durumdur. Bu raporda Dieulafoy lezyonuna bağlı masif gastrointestinal kanaması olan 16 yaşında bir erkek hasta sunulmaktadır. Anahtar Kelimeler: Dieulafoy, gastrointestinal, kanama Dieulafoy's lesion is characterised by a very small area of ulceration with an arteriole at its base, with normal gastrointestinal mucosa surrounding the site. This lesion is a relatively rare, but potentially life-threatening condition. We report a rare case of a 16-year-old boy who presented with massive gastrointestinal bleeding due to Dieulafoy's lesion.

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Heparin provocation for identification and treatment of a gastric Dieulafoy's lesion

Cited by 14 publications

References 15 publications

Video capsule endoscopy for previous overt obscure gastrointestinal bleeding in patients using anti‐thrombotic drugs

Video capsule endoscopy for previous overt obscure gastrointestinal bleeding in patients using anti‐thrombotic drugs

Dieulafoy's lesion: current trends in diagnosis and management

A Rare Etiology of Massive Gastrointestinal Bleeding: Dieulafoy Lesion

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