Aspectos clínicos y tratamiento endoscópico de la hemorragia digestiva por lesión de Dieulafoy

Objective : the aim of the study was to assess the incidence, clinical presentation, location, and response to endoscopic thera py of gastrointestinal bleeding from Dieulafoy’s lesion. Material and method: all consecutive episodes of gastroin testinal bleeding due to Dieulafoy’s lesion seen between 2000 and 2006 were retrospectively reviewed. All main clinical and endo scopic data were collected: type and efectiveness of endoscopic therapy, rebleeding, complications, and mortality during hospitalization. Results: we found 41 patients, 26 males and 15 females, me dian age of 71.19 years. Dieulafoy’s lesion accounted for 1.55% of all gastrointestinal bleeding episodes during the study period. The incidence of Dieulafoy’s lesion was 2.2 cases/100.000 in habitants/year. Active bleeding at endoscopy was present in 85.36%, and comorbidity in 92.68%. The stomach was the most frequent location (60.97%), followed by duodenum (29.26%). En doscopic therapy achieved initial hemostasis in all cases. Three patients (7.31%) initially treated with epinephrine injection showed rebleeding and properly responded to a second session of endoscopic therapy. No surgery was needed. The mortality rate during hospitalization was 4.87%. Conclusions: Dieulafoy’s lesion is an uncommon, but poten tially severe cause of gastrointestinal bleeding. It may be found in any location within the gastrointestinal tract. Endoscopic therapy is effective and safe. Injected epinephrine alone is associated with a higher risk of rebleeding.