title: A single-center United States experience with bleeding Dieulafoy lesions of the small bowel: diagnosis and treatment with single-balloon enteroscopy.
abstract: BACKGROUND
  A Dieulafoy lesion (DL) of the small bowel can cause severe gastrointestinal bleeding, and presents a difficult clinical setting for endoscopists. Limited data exists on the therapeutic yield of treating DLs of the small bowel using single-balloon enteroscopy (SBE).
  
  
  METHODS
  Data were collected from Tampa General Hospital a 1 018-bed teaching hospital affiliated with University of South Florida in Tampa, Florida. Patients were selected from a database of patients that underwent SBE from January 2010 - August 2013.
  
  
  RESULTS
  Eight patients were found to have DL an incidence of 2.6 % of 309 SBE performed for obscure gastrointestinal bleeding. 7/8 were identified in the jejunum, with one found in the duodenum. The mean age of patients with DL was 71.5 years old. 6/8 patients were on some form of anticoagulant/antiplatelet agent. The primary modality of therapy employed was electrocautery, multipolar electrocoagulation in seven patients and APC (argon plasma coagulation) in one patient. In three patients, electrocoagulation was unsuccessful and hemostasis was achieved with clip placement. Three patients required repeat SBE with one found to have rebleeding from a failed clip with hemostasis achieved upon reapplication of one clip.
  
  
  CONCLUSIONS
  In our United States' experience, SBE offers a reasonable therapeutic approach to treat DL of the small bowel with low rates of rebleeding, no adverse events, and no patient requiring surgery.
authors.affiliation: University of South Florida Morsani College of Medicine, Department of Medicine, Tampa, Florida, United States.
authors.forename: Seth
authors.initials: S
authors.lastname: Lipka
authors.affiliation: University of South Florida Morsani College of Medicine, Division of Digestive Diseases and Nutrition, Tampa, Florida, United States.
authors.forename: Roshanak
authors.initials: R
authors.lastname: Rabbanifard
authors.affiliation: University of South Florida Morsani College of Medicine, Department of Medicine, Division of Evidence Based Medicine and Outcomes Research, Tampa, Florida, United States.
authors.forename: Ambuj
authors.initials: A
authors.lastname: Kumar
authors.affiliation: University of South Florida Morsani College of Medicine, Division of Digestive Diseases and Nutrition, Tampa, Florida, United States.
authors.forename: Patrick
authors.initials: P
authors.lastname: Brady