Dieulafoy lesion - Pictures, Prognosis, Recurrence, Treatment


It means a lesion occur in dieulafoy disease. It occurs on an artery named sub mucosal ectatic artery normally present in GIT. This artery is bigger in size as compare to veins and vessels present. Dieulafoy lesion is a rare condition but can be fatal. This lesion can occur in any part of GIT but stomach is rich in these arteries. The lesion to this artery occurs without any reason and forceful bleeding occurs as a result. The most common sites reported are proximal stomach, colon, rectum, small intestine and esophagus (rarely).

This disease mostly occurs in men with the age above 50. The chances of dieulafoy lesion are 0.5 to 14%. In this disease, the bleeding occurs in upper and lower GIT tract along with pain in abdomen. The bleeding may be severe that bloody vomiting can occur along with bloody stool and also blood in cough can be seen. This blood loss can cause anemia in patients and patient may feel weakness. The blood loss with this speed can prove fatal for patient. This condition can exist by birth or may occur later. Some cases reported this condition with a cause of stomach surgery done before.

Dieulafoy lesion Pictures


Dieulafoy lesion - Pictures, Prognosis, Recurrence, Treatment


Dieulafoy lesion - Pictures, Prognosis, Recurrence, Treatment

Dieulafoy lesion Prognosis

               
Advanced endoscopy leads to improvement of disease and early detection of disease. And ultimately it leads to less mortality rate. A big difference is seen in percentage of mortality rate i.e. 80% to 86%. Prognosis of disease is improving and it is shown via use of more endoscopic techniques than use of surgical procedures. And endoscopic technique is considered more effective in stoppage of bleeding occurs due to lesion in dieulafoy disease. Some of the scientists reported that gastro intestinal bleeding in upper region is more easy to treat as compare to bleeding occurs in gastric or duodenal region of GIT.

Dieulafoy lesion Recurrence

               
Investigative studies on recurrence rate is demonstrated via cases reported. A study, based on reported cases, shows that out of 55 patients suffering from DL only 6 patients come back with recurrent bleeding within 4 days of time after endoscopy. In these patients endoscopy is again performed and then 100% result is obtained with no recurrent bleeding. Combined treatment of endoscopy can have very less chances of recurrent bleeding. The treatment with endoscopy is considered safe and effective. But adrenaline monotherapy and arterial bleeding these two conditions are responsible for recurrence of bleeding after endoscopic treatment.

Dieulafoy lesion Treatment

               
Mostly endoscopic treatment is done to treat dieulafoy lesion but sometimes endoscopic ultrasound and endoscopic angiography are also done and considered beneficial as treatment. In treatment the endoscopic technique is used via following way

1st the epinephrine injection is injected in patient and then bipolar or monopolar electrocoagulation, sclerotherapy injection, heater probe, photocoagulation by laser, hemoclipping and banding follows it. For the patients reported with recurrent bleeding the technique used for treatment is interventional radiology along with angiography for selective embolism occurs. Before the introduction of endoscopic treatment, surgical procedures were used to treat dieulafoy lesion.
Dieulafoy lesion - Pictures, Prognosis, Recurrence, Treatment Dieulafoy lesion - Pictures, Prognosis, Recurrence, Treatment Reviewed by Simon Albert on April 11, 2017 Rating: 5
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