Dieulafoy's lesion: current trends in diagnosis and management

M Baxter, E H Aly

Research output: Contribution to journalReview articlepeer-review

179 Citations (Scopus)

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 the bleeding in 90% of patients while angiography is being accepted as a valuable alternative to endoscopy for inaccessible lesions. Currently, surgical intervention is kept for failure of therapeutic endoscopic or angiographic interventions and it should be guided by pre-operative localisation.

CONCLUSIONS: Advances in endoscopy have increased the detection of Dieulafoy's lesions and decreased the mortality from 80% to 8.6%. There are recent encouraging reports on the successful use of laparoscopic surgery in managing symptomatic Dieulafoy's lesions.

Original languageEnglish
Pages (from-to)548-54
Number of pages7
JournalAnnals of the Royal College of Surgeons of England
Volume92
Issue number7
DOIs
Publication statusPublished - Oct 2010

Keywords

  • Acute Disease
  • Angiography
  • Arteries
  • Embolization, Therapeutic
  • Endoscopy, Gastrointestinal
  • Gastrointestinal Hemorrhage
  • Gastrointestinal Tract
  • Humans
  • Prognosis
  • Recurrence
  • Syndrome
  • Journal Article
  • Review

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