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A Journal on Surgery

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Chirurgia 1999 December;12(6):457-60

language: Italian

Dieulafoy's disease

Caputo O. J., Lippolis A., Verzillo F., Simone M., Scardigno A., Memeo V.

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Dieulafoy's disease is a well known entity characterised by a bleeding or clot bearing artery protruding into the intestinal lumen without surrounding ulceration. Its incidence among the causes of acute upper gastrointestinal bleeding varies from 0.5 to 14%. Dieulafoy lesion is diagnosed most often by endoscopy; an experienced endoscopist is necessary as Dieulafoy disease can be easily be overlooked. The first endoscopic session is diagnostic in 82% of cases. The endoscopic treatment by injection therapy has a high success rate(95%). Surgery should only be considered if primary endoscopic treament fails. Three cases of Dieulafoy's gastric lesion are reported. In all cases an emergency endoscopy was performed and treatment with local injection was successful in two cases. Only one patient showed rebleeding episodes and needed surgical treament. Endoscopic injection treatment is safe and represents the first choice in the management of Dieulafoy's disease.

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