Dieulafoy's lesion as a rare cause of gastrointestinal bleeding: a single-center experience

To define the clinical characteristics of Dieulafoy’s lesion (DL),determine the localization features, and investigate endoscopic treatments and their results. This retrospective study included 20 patients who presented to the Department of Gastroenterology due to gastrointestinal (GI) bleeding between January 2015 and December 2019 and were diagnosed with DL. Age, gender, comorbidities, medications used, presentation findings, hemoglobin and hematocrit values at the time of presentation, number and type of transfusions if applied, length of hospitalization in days, mortality/survival, and endoscopic procedure parameters, including the number of procedures, localization of DL, type of bleeding stigmata, and the applied technique were recorded for all patients. Ten (50%) of the patients were women, and the mean age of all patients were 66.8±17.8 years. One or more comorbidities were present in 90% of the patients. The use of acetyl salicylic acid (ASA) was present in five (25%) patients, ASA+ clopidogrel in five (25%), warfarin in two (10%), and non-steroidal anti-inflammatory drugs in two (10%). The most common complaint was observed to be hematemesis and/or melena in 16 patients (80%). DL was most frequently seen in the stomach (n=10; 50%) where it was most commonly located in the proximal corpus (n=6; 60%). The most prevalent bleeding stigma was active bleeding, which was seen in nine (45%) patients during endoscopy. Eight (40%) patients received endoscopic treatment combined with a mechanical method, and nine (45%) patients only received a mechanical treatment (endoscopic band ligation or hemoclip). The median number of hospitalizations was five days (2-22). Transfusion was required by 13 patients (65%). The mortality rate was determined as 5%. DL should be considered especially in older patients with chronic diseases who present with recurrent GI bleeding. An endoscopic examination is the first method to be applied in the diagnosis and treatment of DL. Mechanical methods should be prioritized in endoscopic treatment.