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Endoscopic management of Dieulafoy's lesion using isoamyl-2-cyanoacrylate

World Journal of Gastrointestinal Endoscopy 2013年第8期5卷 417-419页

作者： Abd Elrazek M Aly Abd Elrazek Nakamura Yoko Moriguchi Hiroki Mohamed Afify Mohamed Asar Badr Ismael Magdy Salah Medicine of Liver Transplantation Department of Tropical Medicine Faculty of Medicine Al Azhar University Department of General Surgery and Endoscopy Faculty of Medicine Al Azhar University Department of Medical Informatics Institute of Biomedical Science-University of Tokushima Department of Anesthesia and Intensive Care Al Azhar University

Dieulafoy's lesion (DL) is a rare but important cause of obscure gastrointestinal bleeding that may be over-looked during diagnostic endoscopy. Mortality rates are similar to those of other causes for gastrointestinal bleeding. Diagnosis by upper endoscopy is the modal-ity of choice during acute bleeding. In the absence of active bleeding, the lesion resembles a raised nipple or visible vessel. There are no guidelines regarding effective selective therapy for DL, when diagnosed, en-doscopist experience is the major determinant of the treatment strategy. Following our strategy, an expert endoscopist with a skilled assistant should have a high rate of successful DL diagnosis when an obscured gas-trointestinal lesion is suspected. Cyanoacryltes com-pounds have been used successfully in management of Gastric varices and DLs. To our knowledge, there have been no previous reports regarding use of isoamyl-2-cyanoacrylate (AMCRYLATE ; Concord Drugs Ltd.,Hyderabad, India) as an effective therapy for gastric DL without serious complications. In our case study, isoamyl-2-cyanoacrylate (AMCRYLATE) was effective and safe for treating DL. Surgical wedge resection of the lesion should be considered as a therapeutic option if endoscopic therapy fails.

关键词： Dieulafoy’s lesion isoamyl-2-cyanoacrylate Gastrointestinal bleeding Endoscopy Stomach

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