title: Short-term and long-term benefits of endoscopic hemoclip application for Dieulafoy's lesion in the upper GI tract.
abstract: BACKGROUND
  Dieulafoy's lesion is an important cause of GI bleeding. The results of hemoclip application as the first treatment of choice for Dieulafoy's lesions have not been reported. This study prospectively examined the short- and long-term outcomes of hemoclip application for Dieulafoy's lesions.
  
  
  METHODS
  The study was conducted over a 7-year period beginning in January 1995 during which hemoclip application was used as the first-choice hemostatic treatment for Dieulafoy's lesions. Clinical data, endoscopic findings, and outcome of treatment were evaluated. Long-term outcome for patients was also investigated.
  
  
  RESULTS
  A Dieulafoy's lesion was diagnosed in 34 patients (27 men, 7 women; mean age, 54 years, range 21-81 years) after a mean of 1.2 endoscopies; 79.4% of the patients had active bleeding. Initial hemostasis was attained by hemoclip placement in 94.1%. The rate of recurrent bleeding was 9.3%. No patient required additional treatment such as surgery. The 30-day mortality rate was 2.9% (1 death, unrelated). For the remaining 33 patients, median follow-up was 53.8 months (range 19 to 90 months). Another Dieulafoy's lesion developed in one patient during follow-up, but in a different location compared with the index lesion.
  
  
  CONCLUSIONS
  Endoscopic hemoclip application for Dieulafoy's lesions was effective and safe with short- and long-term benefits.
authors.affiliation: The Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Taro
authors.initials: T
authors.lastname: Yamato
authors.forename: Naoya
authors.initials: N
authors.lastname: Katsumi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Imao
authors.forename: Kei
authors.initials: K
authors.lastname: Aoki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Morita
authors.forename: Miki
authors.initials: M
authors.lastname: Miura
authors.forename: Katsuro
authors.initials: K
authors.lastname: Morozumi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishida
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome