Upper gastrointestinal Dieulafoy lesions and endoscopic treatment: report from a single center

Introduction & Aim: Considering all new endoscopic devices, the endoscopic treatment (ET) is the standard management for Dieulafoy´s lesion (DL). Our objective was to evaluate initial success, rebleeding, emergency surgery need, and mortality rates of patients with DL and ET for first time in a single center from Latin America. Material and methods: Patients from a single third level institution seen in five years were included. DL was defined as an active arterial spurting or visualization of a protruding vessel from a minute mucosal defect (< 3 mm) and a normal surrounding mucosa. Results are expressed by descriptive statistics. The differences between proportions were obtained by the Fisher exact test or by the Chi-square test. Quantitative data were analyzed by U-Mann-Whitney test. Results: A total of 22,283 upper gastrointestinal endoscopies were performed, DL was observed in 20 (0.09%) patients. Eleven (55%) patients were males; median age was 63.5 years (range 22-86). The mean of follow-up period was 90 days (60-550 days). Lesser curvature was the most commonly localization with 7 (35%) patients. Nine patients were treated with single ET. Initial success, rebleeding, and emergent surgery requirement were observed in 90%, 10%, and 15%, respectively. No mortality was observed. Variables like age, gender, localization of DL, hemodynamic instability, active bleeding or type of treatment employed were not related with any end-point. Conclusion: ET is secure and useful in patients with DL and it must be considered as the first line treatment modality. None objective variables were related with initial success, rebleeding and emergent surgery requirement.

Session: Podium Presentation

Program Number: P303

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