1Associate Professor, Department of Surgery, Government Medical College, Kannauj, U.P.
2Assistant Professor, Department of General Surgery, Government Medical College, Haldwani, Uttarakhand
3Professor & Head, Department of Surgery, School of Medical Sciences, Sharda University, Greater Noida, U.P.
*Corresponding author: Dr. Basant Mohan Singhal E-mail: singhalbm@gmail.com
Online published on 14 October, 2016.
The Dieulafoy's lesion is a unique vascular abnormality accounting for 1–5.8% cases of acute non-variceal gastrointestinal bleeding. It is a uncommon, but potentially life-threatening condition. The objective of our study was to review the current trends in the diagnosis and management of Dieulafoy's lesion.
A thorough literature search was performed for published English articles, using the search words ‘Dieulafoy’(s)’. All retrieved articles were analysed and the findings are summarised in this article.
Endoscopic therapy is the mainstay in the management of DL as it is safe and long term results are excellent (mortality <10%). Mechanical therapies are more effective in controlling bleeding in DL. Surgery is reserved as salvage therapy in 5% of cases where repeated endoscopic procedures fail to achieve long term haemostasis. In patients with failed endoscopic procedures who are poor risk for surgery, angiographic embolization may be successful.
Presently mortality associated with this lesion is more due to co-morbidities affecting the patients rather than the continued GI bleed from the lesion. We need to define criteria for selection of endoscopic modality according to the type and site of the lesion rather than a decision based on personal choice of attending physician.
Dieulafoy's lesion, Massive Gastro-intestinal bleeding, Acute Non-variceal gastrointestinal
