BACKGROUND: To investigate whether endosonography can help in the detection and treatment of Dieulafoy's disease, we examined eight patients with suspicion of Dieulafoy's disease. METHODS: Between December 1992 and April 1995, eight patients were referred because of suspicion of Dieulafoy's disease. Seven presented with upper gastrointestinal bleeding and one with a tiny ulcer. In all eight patients the stomach was examined with an Olympus GF-UM20 echoendoscope. The stomach was filled with 200 to 400 ml of water after which the body, fundus, and cardia were carefully visualized. RESULTS: In all eight patients a clearly visible, relatively large caliber (2 to 3 mm) vessel was seen to penetrate the muscularis propria and could be followed running through the submucosa for 2 to 4 cm. Subsequently four patients received sclerotherapy, three under endosonographic guidance. Follow-up of all patients (median 10 months), showed recurrent bleeding in two patients, 3 and 5 months after sclerotherapy. One was then diagnosed with a duodenal ulcer and one with recurrent bleeding from the Dieulafoy's lesion. CONCLUSIONS: Endosonography is useful in the detection of Dieulafoy's disease in patients with unexplained upper gastrointestinal bleeding. Sclerotherapy can be performed during the same procedure, with endosonography-guided injection of the sclerosing agent near the abnormal vessel.
BACKGROUND: To investigate whether endosonography can help in the detection and treatment of Dieulafoy's disease, we examined eight patients with suspicion of Dieulafoy's disease. METHODS: Between December 1992 and April 1995, eight patients were referred because of suspicion of Dieulafoy's disease. Seven presented with upper gastrointestinal bleeding and one with a tiny ulcer. In all eight patients the stomach was examined with an Olympus GF-UM20 echoendoscope. The stomach was filled with 200 to 400 ml of water after which the body, fundus, and cardia were carefully visualized. RESULTS: In all eight patients a clearly visible, relatively large caliber (2 to 3 mm) vessel was seen to penetrate the muscularis propria and could be followed running through the submucosa for 2 to 4 cm. Subsequently four patients received sclerotherapy, three under endosonographic guidance. Follow-up of all patients (median 10 months), showed recurrent bleeding in two patients, 3 and 5 months after sclerotherapy. One was then diagnosed with a duodenal ulcer and one with recurrent bleeding from the Dieulafoy's lesion. CONCLUSIONS: Endosonography is useful in the detection of Dieulafoy's disease in patients with unexplained upper gastrointestinal bleeding. Sclerotherapy can be performed during the same procedure, with endosonography-guided injection of the sclerosing agent near the abnormal vessel.
Authors: Carlo Fabbri; Carmelo Luigiano; Andrea Lisotti; Vincenzo Cennamo; Clara Virgilio; Giancarlo Caletti; Pietro Fusaroli Journal: World J Gastroenterol Date: 2014-07-14 Impact factor: 5.742
Authors: G Orlando; I M Luppino; R Gervasi; M A Lerose; B Amato; R Spagnuolo; R Marasco; P Doldo; A Puzziello Journal: BMC Surg Date: 2012-11-15 Impact factor: 2.102