Endoscopic treatment of dieulafoy lesions and risk factors for rebleeding.
OBJECTIVE
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.
Lim
Won
W
Department of Internal Medicine, Pusan National University College of Medicine, Seo-gu, Busan, Korea.
Kim
Tae Oh
TO
Park
Su Bum
SB
Rhee
Ha Rin
HR
Park
Jin Hyun
JH
Bae
Jung Ho
JH
Jung
Hong Ryeul
HR
Kim
Mi Ra
MR
Lee
NaRiA
N
Lee
Sun Mi
SM
Kim
Gwang Ha
GH
Heo
Jeong
J
Song
Geun Am
GA
D000328:Adult; D000368:Aged; D001165:Arteriovenous Malformations / Q000150:complications / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors