Dieulafoy's lesion: new diagnosis usinghigh? definition endoscopy and treatment withisoamyl 2 cyanoacrylate [Amcrylate]

ABSTRACT

Dieulafoy's lesion [DL] is a rare but important cause of gastrointestinal [GI] bleeding, accountingfor up to 6% of the cases of nonvariceal bleeding in the upper GI tract and 1-2% of all GIhemorrhages. Mortality rates are similar to those of other causes for GI bleeding. Following ourstrategy, an expert endoscopist with a skilled assistant should have a high rate of successful DL diagnosis when an obscured GI lesion is suspected. In our seven case study, we thinkit was feasible to use high?definition Fujinon intelligent chromoendoscopy to diagnose DL. Isoamyl 2 cyanoacrylate [Amcrylate] was effective and safe for treating DL as well as wereother strategies, including ethanolamine oleate, band ligation, and nebutyle 2 cyanoacrylate. Surgical wedge resection of the lesion should be considered as a therapeutic option if endoscopic therapy fails