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KMID : 0338420090240040318
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The Korean Journal of Internal Medicine
2009 Volume.24 No. 4 p.318 ~ p.322
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Endoscopic Treatment of Dieulafoy Lesions and Risk Factors for Rebleeding
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Lim Won
Kim Tae-Oh
Park Su-Bum
Rhee Ha-Rin
Park Jin-Hyung
Bae Jung-Ho
Jung Hong-Ryeul
Kim Mi-Ra
Lee Naria
Lee Sun-Mi
Kim Gwang-Ha
Heo Jeong
Song Geun-Am
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Abstract
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Background/Aims : Dieulafoy lesions are an important cause of upper gastrointestinal bleeding. The purpose of
this study was to assess the efficacy of endoscopic treatment for these lesions and to identify the possible
predictive factors for rebleeding associated with clinical and endoscopic characteristics.
Methods: Records from 44 patients admitted with Dieulafoy bleeding between January 2006 and December
2007 were reviewed. We retrospectively analyzed the clinical and endoscopic findings and then correlated the
rebleeding risk factors with Dieulafoy lesions.
Results: Primary hemostasis was achieved by endoscopic treatment in 39 patients (88.6%). There were no
significant differences between the rebleeding and non-rebleeding groups with respect to age, gender, initial
hemoglobin levels, presence of shock, concurrent disease, location of bleeding, or initial hemostatic treatment
methods. However, the use of non-steroidal anti-inflammatory drugs or anticoagulants (p=0.02) and active stages
in the Forrest classification (p<0.01) were risk factors for rebleeding after endoscopic therapy.
Conclusions: Endoscopic therapy is effective and safe for treating Dieulafoy lesions, and it has both short- and
long-term benefits. Early identification of risk factors such as the use of non-steroidal anti-inflammatory drugs or
anticoagulants and the Forrest classification of bleeding predict the outcome of Dieulafoy lesions.
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KEYWORD
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Dieulafoy, Gastrointestinal hemorrhage, Endoscopy, Hemostasis, Anticoagulants
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