Endoscopic treatment of Dieulafoy’s lesion

Yıl 2016, Cilt: 15 Sayı: 3, 102 - 105, 02.01.2017

Muhammet Yener Akpınar , Erkin Öztaş , Derya Aras İsmail Hakkı Kalkan , Meral Akdoğan Sabite Kaçar , Yasemin Özderin Özin Zeki Mesut Yalın Kılıç Bülent Ödemiş Selçuk Dişibeyaz , Ertuğrul Kayaçetin

https://doi.org/10.17941/agd.371765

Cited By: 1

Öz

Background and Aims: This study describes the demographic features
of patients with Dieulafoy’s lesion, their endoscopic findings, endoscopic
treatments, and their response to therapy. Materials and Methods:
Endoscopy reports were screened for Dieulafoy’s lesion between 2008
and 2016. Patients with this diagnosis were also screened to determine
initial laboratory findings, endoscopic treatments, and response to therapy.
Results: A total of 18 patients were diagnosed with Dieulafoy’s lesion.
The most frequent presentation was melena. Seven patients died
during the follow-up period. Clip was the most frequent endoscopic
treatment method either alone or in combination with other endoscopic
modalities. There was no difference in mortality between patients
who were treated with clip alone and those treated with the combined
modality (p=0.9). When patients treated with adrenalin and heater
were excluded, no difference in mortality was observed between the
clip group and the clip combined with other endoscopic treatment
group (p=0.6). Conclusion: This study demonstrated that additional
endoscopic methods such as adrenalin and/or heater did not reduce
mortality compared with clip monotherapy. 

Anahtar Kelimeler

Dieulafoy’s lesion, endoscopic treatment, gastrointestinal system bleeding

Dieulafoy lezyonunda endoskopik tedavi

Öz

Giriş ve Amaç: Çalışmamızda kliniğimizde Dieulafoy Lezyonu tanısı konulan
hastaları, yapılan endoskopik tedavileri ve bu tedavilerin başarı
oranlarını ortaya koymayı hedefledik. Gereç ve Yöntem: Kliniğimizde
2008-2016 tarihleri arasında endoskopileri yapılan hastalar ‘Dieulafoy
Lezyonu’ tanısı için retrospektif olarak tarandı. Endoskopik tanısı Dieulafoy
lezyonu olan hastaların servis yatışları, laboratuvar değerleri, kaç
gün yattıkları, hastalıklarının nihai sonucu tespit edildi. Bulgular: 18
hasta çalışmaya alındı. En sık başvuru şikayeti melenaydı. Hastaların
yedi tanesinde mortalite gerçekleşti. Klips, tek başına veya kombine
olmak üzere en sık başvurulan endoskopik tedavi yöntemiydi. Klipsin
tek başına uygulandığı hastalarla, klipsle beraber veya klips olmadan
kombine tedavi uygulanan hastalar arasında mortalite açısından fark
yoktu (p=0,9). Adrenalinle beraber heater yapılan olgular dışlanarak
yapılan subgrup analizinde klips uygulanan hastalarla klipsle beraber
diğer yöntemlerin yapıldığı hastalar arasında mortalite karşılaştırıldı. İki
grup arasında yine mortalite açısından bir fark yoktu (p=0,6). Sonuç:
Çalışmamız klips tedavisine eklenecek adrenalin ve/veya heater koagü-
lasyon gibi yöntemlerle yapılan kombine tedavinin mortaliteyi azaltmada
klips monoterapisine kıyasla herhangi bir üstünlüklerinin olmadığını
göstermiştir.

Anahtar Kelimeler

Dieulafoy lezyonu, endoskopik tedavi, gastrointestinal sistem kanaması

Kaynakça

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