Gastrointestinal bleeding from Dieulafoy’s lesion: Clinical presentation, endoscopic findings, and endoscopic therapy

Table 3 Therapy for Dieulafoy’s lesion

Pre-endoscopic therapy

Secure IV access using multiple, large bore catheters

Volume resuscitation initially using crystalloid followed by transfusions of packed erythrocytes as dictated by serial hematocrit determinations and tempo of bleeding

Endoscopic therapies

Mechanical therapies

Hemoclips

Band ligation

Injection therapies

Epinephrine injection

Absolute alcohol

Ablative therapies

Heater probe

Electrocoagulation: Bicap, gold probe, etc.,

APC (argon plasma coagulation)

Combination therapies

Usually epinephrine injection therapy followed by:

Heater probe

Hemoclip

Or APC

Interventional angiography

Embolization

Pledgelets

Metal coils

Balloon occlusion

Surgery

Mostly salvage therapy after failure of other interventional therapies

APC: Argon plasma coagulation.