Dieulafoy's lesions (DLs) are rare and cause gastrointestinal bleeding resulting from erosion of dilated submucosal vessels. The most common Missing: ulcera | Must include: ulcera. KEY WORDS: Rectal Dieulafoy-like lesion - Rectal bleeding - Endoscopic therapy. Ulcera rettale simil-Dieulafoy - Sanguinamento rettale - Terapia endoscopica. No surrounding mucosal ulcera- tions are generally found. Although a congenital origin of the lesion is supposed, it is found more often in adult.
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Among those who had unsuccessful treatment with aethoxysklerol injection, 13 were treated with hemoclip hemostasis and ulcera dieulafoy underwent surgical operation; 9 cases were successful in the injection therapy. Among the cases with unsuccessful treatment with hemoclip hemostasis, 7 were treated with injection of aethoxysklerol and 3 cases ulcera dieulafoy surgical operation; 4 cases were successful in the treatment with hemoclip hemostasis.
Only 1 case had unsuccessful treatment with a combined therapy of hemoclip hemostasis and aethoxysklerol injection, and surgery was then performed.
No serious complications of perforation occurred in ulcera dieulafoy patients whose bleeding was treated with the endoscopic hemostasis, and no re-bleeding was found during a 1-year follow-up. There were 70 males and 37 females, with a mean age of 54 years.
No obvious epigastric discomfort and abdominal pain were noted, and there was no history of ulcera dieulafoy ulcer or heredity disease.
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- Dieulafoy's lesion
- Efficacy of endoscopic therapy for gastrointestinal bleeding from Dieulafoy’s lesion
Diagnostic standards 1 The bottom of the ulcer had exposed vessels most were dilated small arteries ; 2 The ulcer was superficial and small, and the diameter was less ulcera dieulafoy 0.
Endoscopic findings Emergent endoscopic examination was performed for ulcera dieulafoy the patients. There is no specific radiological view of the lesion.
Duodenal and jejunal Dieulafoy’s lesions: optimal management
The angiographic findings include extravasation of contrast from an eroded artery that may appear normal. However, existence of a tortuous and ectatic artery in angiography can provide ulcera dieulafoy information for the diagnosis of DL.
Technetium scintography was used in 2 studies but it was unable to show any bleeding site. If standard angiography fails, formal heparin therapy with an angiogram can be used to show the exact bleeding point. The selective placement of an ulcera dieulafoy catheter into the affected artery may also have resuscitative and possible therapeutic benefits.
Ulcera dieulafoy vasopressin installation or embolization may aid in slowing any hemorrhaging, thereby allowing more time for ulcera dieulafoy resuscitative efforts. Patients who undergo embolization are at risk of ischemia of the non-involved jejunal segments unless the cathether has been placed distal to the subsegmental branches.
Angiographic embolization is the choice of treatment in suitable patients.
Angiography failed to show the bleeding point in 2 of 4 jejunal DL patients, and embolization was also ulcera dieulafoy in these patients. Patients who underwent successful embolization for the treatment of DL were also shown to have another DL in another organ.
It is a method of choice for small intestine imaging after colonoscopy ulcera dieulafoy endoscopy for mid-GI bleeding in hemodynamically stable patients.
Efficacy of endoscopic therapy for gastrointestinal bleeding from Dieulafoy’s lesion
The decision as to whether the initial enteroscopy was performed from an oral or anal approach was based ulcera dieulafoy on clinical presentation and the result of capsule endoscopy. If capsule endoscopy reveals a possible bleeding source within the proximal two-thirds of the small bowel, an oral route enteroscopy is performed first because it can reach the bleeding point.
If no ulcera dieulafoy is detected along the oral route, a ulcera dieulafoy tattoo is placed to mark the deepest insertion point and the anal route is then used.
Tattooing can also be used for marking the lesion s during surgery when endoscopic treatments fail.
Tattooing the bleeding site with India ulcera dieulafoy maybe helpful for future identification in the event of recurrent bleeding.