Nojkov B, Cappell MS. Gastrointestinal bleeding from Dieulafoy’s lesion: Clinical presentation, endoscopic findings, and endoscopic therapy. World J Gastrointest Endosc 2015; 7(4): 295-307 [PMID: 25901208 DOI: 10.4253/wjge.v7.i4.295]
Corresponding Author of This Article
Mitchell S Cappell, MD, PhD, Division of Gastroenterology and Hepatology, William Beaumont Hospital, MOB 602, 3535 W. Thirteen Mile Road, Royal Oak, MI 48073, United States. mscappell@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Apr 16, 2015; 7(4): 295-307 Published online Apr 16, 2015. doi: 10.4253/wjge.v7.i4.295
Gastrointestinal bleeding from Dieulafoy’s lesion: Clinical presentation, endoscopic findings, and endoscopic therapy
Borko Nojkov, Mitchell S Cappell
Borko Nojkov, Mitchell S Cappell, Division of Gastroenterology and Hepatology, William Beaumont Hospital, Royal Oak, MI 48073, United States
Borko Nojkov, Mitchell S Cappell, Oakland University William Beaumont School of Medicine, Royal Oak, MI 48073, United States
Author contributions: Both authors ontributed equally to this work.
Conflict-of-interest: None for all authors. This paper does not discuss any confidential pharmaceutical data reviewed by Dr. Cappell as a consultant for the United States Food and Drug Administration Advisory Committee on Gastrointestinal Drugs.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mitchell S Cappell, MD, PhD, Division of Gastroenterology and Hepatology, William Beaumont Hospital, MOB 602, 3535 W. Thirteen Mile Road, Royal Oak, MI 48073, United States. mscappell@yahoo.com
Telephone: +1-248-5511227 Fax: +1-248-5515010
Received: October 29, 2014 Peer-review started: November 2, 2014 First decision: December 12, 2014 Revised: December 20, 2014 Accepted: January 9, 2015 Article in press: January 12, 2015 Published online: April 16, 2015
Core Tip
Core tip: Dieulafoy’s lesion is an important cause of acute gastrointestinal bleeding. Dieulafoy’s lesions maintain an abnormally large caliber despite their peripheral, submucosal, location. Dieulafoy’s lesions typically present with severe, active, gastrointestinal bleeding. About 75% of lesions are located in the stomach, most commonly close to the gastroesophageal junction, but lesions can occur in duodenum and esophagus. Endoscopy is the first diagnostic test (70% diagnostic yield). Lesions typically appear at endoscopy as pigmented protuberances from exposed vessel stumps, with minimal surrounding erosions. Endoscopic therapy, including clips, sclerotherapy, argon plasma coagulation, thermocoagulation, or electrocoagulation, is the recommended initial therapy, with primary hemostasis achieved in nearly 90% of cases. Mortality of bleeding from this lesion is 9%-13%.
