title: The efficiency of endoclips in maintaining the gastrointestinal bleeding-related Dieulafoy's lesion.
abstract: BACKGROUND
  Dieulafoy's lesion (DL) is a relatively uncommon medical condition characterized by a large tortuous arteriole in the submucosa of any part of gastrointestinal (GI) tract wall that bleeds via erosion likely caused in the submucosal surface by protrusion of the pulsatile arteriole. Compared with other endoscopic hemostatic techniques, clipping alone for DL is limited.
  
  
  OBJECTIVE
  The aim of the present case series study is to identify common clinical and endoscopic features, rates of occurrence, to review the outcome of endoscopic management of upper GI tract DL, and to illustrate the use and the efficiency of endoclips in maintaining the GI bleeding due to DL.
  
  
  METHODS
  This case series was conducted at Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital. The patients who were admitted to the emergency department of Dıskapı Yıldırım Beyazıt Educational and Research Hospital underwent gastrointestinal system (GIS) endoscopy between 2008 and 2013 and were assessed retrospectively. Five cases of GI bleeding related to DL were given endoscopic treatment with hemoclip application. Clinical data, endoscopic findings, and the effects of the therapy were evaluated.
  
  
  RESULTS
  The median number of endoscopic hemoclips application in first endoscopy was 4 (2-9). Rebleeding developed in all patients who had hemoclips applied. Re-endoscopy was performed in three of these patients, which controlled the bleeding. Two patients were transferred to surgery.
  
  
  CONCLUSIONS
  Combination of endoscopic injection and mechanical therapies seems a suitable method for maintaining upper GIS bleeding due to DL. Also, further studies are needed to better define the best endoscopic approach for the treatment of DL.
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey. fatih_ares@yahoo.com.tr.
authors: Fatih
authors: F
authors: Karaahmet
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey.
authors: Serta
authors: S
authors: Kılıncalp
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey.
authors: Yusuf
authors: Y
authors: Coskun
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey.
authors: Mevlut
authors: M
authors: Hamamci
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey.
authors: Hakan
authors: H
authors: Akinci
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey.
authors: Yusuf
authors: Y
authors: Ustun
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey.
authors: Zahide
authors: Z
authors: Simsek
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey.
authors: Elife
authors: E
authors: Erarslan
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey.
authors: Sahin
authors: S
authors: Coban
authors: Department of Gastroenterology, Dıskapı Yıldırım Beyazıt Educational and Research Hospital, 06080, Altındag, Ankara, Turkey.|Department of Gastroenterology, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey.
authors: Ilhami
authors: I
authors: Yuksel
mesh_terms: D000328:Adult; D000368:Aged; D001160:Arterioles / Q000002:abnormalities / Q000601:surgery; D004867:Equipment Design; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments; D014102:Torsion Abnormality / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Dieulafoy’s lesion; Endoscopic hemostasis; Gastrointestinal tract bleeding; Hemocliping; Management