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Can Segmental Branch Embolization of the Left Gastric Artery Be an Alternative in the Treatment of Recurrent Dieulafoy Lesion Bleeding? A Case report

Year 2024, Volume: 23 Issue: 2, 67 - 70, 27.08.2024
https://doi.org/10.17941/agd.1529249

Abstract

Dieulafoy lesions, rare developmental vascular malformations within the gastrointestinal system, present a diagnostic challenge due to their inconspicuous nature. These lesions, primarily located near the esophagogastric junction, can lead to life-threatening bleeding. Although accounting for approximately 1.5-2% of upper gastrointestinal bleeding cases, the exact prevalence remains uncertain. Commonly diagnosed through esophagogastroduodenoscopy, the small size of these lesions often results in oversight during initial endoscopy, necessitating a high index of suspicion, especially in cases of recurrent bleeding. While endoscopic methods are the standard treatment, this case presentation introduces the use of embolization as a rare but effective modality in managing recurrent Dieulafoy lesion bleeding. The presented case underscores the importance of diverse treatment approaches and contributes valuable insights to the medical literature, enhancing the understanding and management of this infrequent yet potentially serious condition.

References

  • 1) Shin HJ, Ju JS, Kim KD, et al. Risk Factors for Dieulafoy Lesions in the Upper Gastrointestinal Tract. Clin Endosc. 2015;48(3):228-33.
  • 2) British Society of Gastroenterology Endoscopy Committee. Non-variceal upper gastrointestinal haemorrhage: guidelines. Gut. 2002;51(Suppl 4):iv1-iv6.
  • 3) Kusnik A, Mostafa MR, Sharma RP, Chodos A. Dieulafoy Lesion: Scope it Until You Find it. Cureus. 2023;15(3):e36097.
  • 4) Nojkov B, Cappell MS. Gastrointestinal bleeding from Dieulafoy's lesion: Clinical presentation, endoscopic findings, and endoscopic therapy. World J Gastrointest Endosc. 2015; 7(4):295-307.
  • 5) Cappell MS. Therapeutic endoscopy for acute upper gastrointestinal bleeding. Nat Rev Gastroenterol Hepatol. 2010;7(4):214-29.
  • 6) Han C, Ling X, Liu J, Lin R, Ding Z. Management of non-variceal upper gastrointestinal bleeding: role of endoscopic ultrasound-guided treatments. Therap Adv Gastroenterol. 2022;15:17562848211056148.
  • 7) Barakat M, Hamed A, Shady A, Homsi M, Eskaros S. Endoscopic band ligation versus endoscopic hemoclip placement for Dieulafoy's lesion: a meta-analysis. Eur J Gastroenterol Hepatol. 2018;30(9):995-996.
  • 8) Rodriguez CT, Bittle JSH, Kwarcinski TJ, Juarez S, Hinshelwood JR. Dieulafoy lesions and gastrointestinal bleeding. Proc (Bayl Univ Med Cent). 2020;33(4):633-4.
  • 9) Jeon HK, Kim GH. Endoscopic Management of Dieulafoy's Lesion. Clin Endosc. 2015; 48(2):112-20.

Tekrarlayan Dieulafoy Lezyon Kanamalarının Tedavisinde Sol Gastrik Arter Segmental Dal Embolizasyonu Bir Alternatif Olabilir mi? Olgu Sunumu

Year 2024, Volume: 23 Issue: 2, 67 - 70, 27.08.2024
https://doi.org/10.17941/agd.1529249

Abstract

Dieulafoy lezyonları, gastrointestinal sistemde nadir görülen gelişimsel vasküler malformasyonlardır ve göze çarpmamaları nedeniyle tanıda zorluklar yaşanmaktadır. Bu lezyonlar genellikle özofagogastrik bileşke yakınında bulunur ve yaşamı tehdit eden kanamalara neden olabilir. Üst gastrointestinal kanama vakalarının yaklaşık %1.5-2'sini oluşturduğu düşünülse de, prevalansı belirsizdir. Özofagogastroduodenoskopi ile teşhis edilen bu lezyonların boyutunun küçük olması, genellikle ilk endoskopide gözden kaçmasına neden olur ve özellikle tekrarlayan kanama durumlarında şüphe uyandırmalıdır. Endoskopik yöntemler standart tedavi iken, bu vaka sunumu tekrarlayan Dieulafoy lezyon kanamaları yönetiminde embolizasyonun etkin bir tedavi metodu olarak kullanımını tanıtmaktadır. Sunulan vaka, çeşitli tedavi yaklaşımlarının önemini vurgular ve seyrek ancak potansiyel olarak ciddi olan Dieulafoy lezyonlarının anlaşılmasına ve yönetimine katkıda bulunur.

References

  • 1) Shin HJ, Ju JS, Kim KD, et al. Risk Factors for Dieulafoy Lesions in the Upper Gastrointestinal Tract. Clin Endosc. 2015;48(3):228-33.
  • 2) British Society of Gastroenterology Endoscopy Committee. Non-variceal upper gastrointestinal haemorrhage: guidelines. Gut. 2002;51(Suppl 4):iv1-iv6.
  • 3) Kusnik A, Mostafa MR, Sharma RP, Chodos A. Dieulafoy Lesion: Scope it Until You Find it. Cureus. 2023;15(3):e36097.
  • 4) Nojkov B, Cappell MS. Gastrointestinal bleeding from Dieulafoy's lesion: Clinical presentation, endoscopic findings, and endoscopic therapy. World J Gastrointest Endosc. 2015; 7(4):295-307.
  • 5) Cappell MS. Therapeutic endoscopy for acute upper gastrointestinal bleeding. Nat Rev Gastroenterol Hepatol. 2010;7(4):214-29.
  • 6) Han C, Ling X, Liu J, Lin R, Ding Z. Management of non-variceal upper gastrointestinal bleeding: role of endoscopic ultrasound-guided treatments. Therap Adv Gastroenterol. 2022;15:17562848211056148.
  • 7) Barakat M, Hamed A, Shady A, Homsi M, Eskaros S. Endoscopic band ligation versus endoscopic hemoclip placement for Dieulafoy's lesion: a meta-analysis. Eur J Gastroenterol Hepatol. 2018;30(9):995-996.
  • 8) Rodriguez CT, Bittle JSH, Kwarcinski TJ, Juarez S, Hinshelwood JR. Dieulafoy lesions and gastrointestinal bleeding. Proc (Bayl Univ Med Cent). 2020;33(4):633-4.
  • 9) Jeon HK, Kim GH. Endoscopic Management of Dieulafoy's Lesion. Clin Endosc. 2015; 48(2):112-20.
There are 9 citations in total.

Details

Primary Language English
Subjects Gastroenterology and Hepatology
Journal Section Articles
Authors

Gamze Sönmez This is me 0009-0001-3488-0283

Serez İleri This is me 0009-0007-6288-8745

Ferdi Çay 0000-0001-9589-7495

Bora Peynircioğlu 0000-0002-1457-4721

Onur Keskin This is me 0000-0002-9790-8204

Publication Date August 27, 2024
Submission Date November 20, 2023
Acceptance Date February 15, 2024
Published in Issue Year 2024 Volume: 23 Issue: 2

Cite

APA Sönmez, G., İleri, S., Çay, F., Peynircioğlu, B., et al. (2024). Can Segmental Branch Embolization of the Left Gastric Artery Be an Alternative in the Treatment of Recurrent Dieulafoy Lesion Bleeding? A Case report. Akademik Gastroenteroloji Dergisi, 23(2), 67-70. https://doi.org/10.17941/agd.1529249

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