Dieulafoy's lesion treated with argon plasma coagulation and injection sclerotherapy: A rare case report

Yıl 2014, Cilt: 22 Sayı: 1, - , 01.04.2014

Şehmus Ölmez Bünyamin Sarıtaş Mehmet Aslan Ahmet Cumhur Dülger İbrahim Aydın

https://doi.org/10.17940/endoskopi.74793

Öz

Dieulafoy's lesion is an uncommon, but important, cause of upper gastrointestinal bleeding. Dieulafoy's lesion is usually seen in the stomach, but sometimes can be seen in the small or large bowel. Typically, it is located within 6 cm of the esophagogastric junction, generally along the lesser curvature of the stomach. Various methods with endoscopy are used to control the hemostasis due to these lesions, but the most suitable endoscopic treatment method for treating bleeding Dieulafoy's lesion is not yet well established. Argon plasma coagulation has been used successfully in upper gastrointestinal bleeding; however, the experience using argon plasma coagulation to treat Dieulafoy's lesion is quite limited. Herein, we report a case with a bleeding gastric Dieulafoy's lesion that was treated using a combined endoscopic approach with injection therapy and argon plasma coagulation

Anahtar Kelimeler

Dieulafoy lesion, gastrointestinal bleeding, argon plasma coagulation, treatment

Dieulofaloy lezyonunun kombine tedavisi: Olgu sunumu

Öz

Dieulafoy lezyonu nadir görülen ancak önemli bir üst gastrointestinal kanama nedenidir. Sıklıkla midede görülmekle birlikte ince ve kalın bağırsaklarda da görülebilir. Tipik olarak gastroözofageal bileşkeden sonraki 6 cm içinde, küçük kurvatur yönünde yerleşir. Bu lezyonlara bağlı kanamada, hemostazı sağlamak için değişik endoskopik yöntemler kullanılır ve kanayan Dieulafoy lezyonu tedavisi için en uygun endoskopik tedavi yöntemi henüz iyi tanımlanmamıştır. Argon plazma koagülasyonu üst gastrointestinal kanamada başarılı bir şekilde kullanılmasına rağmen Dieulafoy lezyonuna bağlı kanamalarda kullanımı sınırlıdır. Burada enjeksiyon tedavisi ve argon plazma koagülasyonu ile kombine olarak tedavi edilen, kanayan gastrik Dieulafoy lezyonu olan olguyu sunacağız.

Anahtar Kelimeler

Dieulafoy lezyonu, gastrointestinal kanama, argon plazma koagülasyonu, tedavi

Kaynakça

• Sone Y, Kumada T, Toyoda H, et al. Endoscopic management and fol- low up of Dieulafoy lesion in the upper gastrointestinal tract. Endoscopy 2005; 37: 449-53.
• Ahn DW, Lee SH, Park YS, et al. Hemostatic efficacy and clinical out- come of endoscopic treatment of Dieulafoy’s lesions: comparison of en- doscopic hemoclip placement and endoscopic band ligation. Gastroin- test Endosc 2012; 75: 32-8.
• Linhares MM, Filho BH, Schraibman V, et al. Dieulafoy lesion: endo- scopic and surgical management. Surg Laparosc Endosc Percutan Tech 2006; 16: 1-3.
• Jamanca-Poma Y, Velasco-Guardado A, Piñero-Pérez C, et al. Prognostic factors for recurrence of gastrointestinal bleeding due to Dieulafoy’s le- sion. World J Gastroenterol 2012; 40: 5734-8.
• Manner H, May A, Faerber M, Rabenstein T, Ell C. Safety and efficacy of a new high power argon plasma coagulation system (hp-APC) in lesions of the upper gastrointestinal tract. Dig Liver Dis 2006; 38: 471-8.
• Iacopini F, Petruzziello L, Marchese M, et al. Hemostasis of Dieulafoy’s lesions by argon plasma coagulation. Gastrointest Endosc 2007; 66: 20-6.
• Baxter M, Aly EH. Dieulafoy’s lesion: current trends in diagnosis and management. Ann R Coll Surg Engl 2010; 92: 548-54.
• Yarze JC. Routine endoscopic “marking” of Dieulafoy like lesions. Am J Gastroenterol 2001; 96: 264-5.
• Lara LF, Sreenarasimhaiah J, Tang SJ, Afonso BB, Rockey DC. Dieulafoy lesions of the GI tract: localization and therapeutic outcomes. Dig Dis Sci 2010; 55: 3436-41.
• Yarze JC. Argon plasma coagulation of Dieulafoy’s lesions. Gastrointest Endosc 2006; 63: 733.
• Souza JLS. Treatment of Dieulafoy’s lesion of the right colon with epi- nephrine injection and argon plasma coagulation. Endoscopy 2009; 41: E192.