A Retrospective and Clinical Analysis of Dieulafoy's Lesion (DL)

作     者：Satish Gurung 

作者单位：大连医科大学 

学位级别：硕士

导师姓名：Wang Ying De

授予年度：2006年

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主      题：Dieulafoy’s Lesion (DL) Hematemesis Endoscopy Hemostasis 

摘      要：Aim: Dieulafoy’s Lesion is an emergency condition. It’s a rare disease causing massive GI bleeding. It accounts for 1.5% of cases of acute GI bleeding. Its obvious clinical features are hematemesis or melena or both hematemesis and melena accompanied by hemodynamic symptoms such as fatigue, palpitation, dyspnea and upper abdominal discomfort. Endoscopy plays the crucial role in both diagnosing and treating the DL. Under endoscopies, there are many alternatives as a treatment such as hemoclips, sclerotherapy, purified ethanol, and epinephrine injection. Its mortality is still high despite of advanced endoscopic therapies. However compare to past records, its mortality has somehow decreased. We aim to report our experience in the clinical features, diagnosis and treatment choice along with mortality rate. Methods: A retrospective and clinical analysis of 18 patients with DL between 1990-2005 was done. The clinical characteristics including sex, age, presenting symptoms, shock, bleeding amount, blood pressure and hemoglobin at the time of hospitalization, blood transfusion requirement and its amount, patients past history along with requirement of surgery and total number of days hospitalized were recorded. The study was designed as a retrospective, analysis of importance of endoscopy in diagnosing and treating DL during its active bleeding of DL. Based on the endoscopic findings, the location of DL, picture of bleeding, presence of *** and endoscopic treatment were recorded.