Dieulafoy's lesion – an uncommon cause of upper GI bleed (diagnosis and treatment) | regularcrisis скачать в хорошем качестве

Dieulafoy's lesion – an uncommon cause of upper GI bleed (diagnosis and treatment) | regularcrisis

The above case is from the daily challenges faced in ER and ICU. A Dieulafoy's lesion is a dilated aberrant submucosal vessel that erodes the overlying epithelium in the absence of a primary ulcer. The submucosal artery does not undergo normal branching within the wall of the stomach. As a result, the caliber of the artery is in the range of 1 to 3 mm, approximately 10 times the normal caliber of mucosal capillaries. Dieulafoy's lesions are usually located in the proximal stomach along the lesser curvature, near the esophagogastric junction (typically within 5 cm), although they have been found in all areas of the GI tract, including the esophagus, duodenum, and colon. The etiology of Dieulafoy's lesion is unknown. Bleeding episodes are often self-limited, although bleeding can be recurrent and profuse. Endoscopy is the diagnostic modality of choice to detect a Dieulafoy's lesion and is particularly helpful when performed during acute bleeding. Endoscopic hemostasis may be achieved with a combination of epinephrine injection followed by bipolar probe coagulation, heater probe thermal coagulation, or hemoclip placement. If rebleeding recurs after one endoscopic treatment, therapeutic options include repeat endoscopic hemostasis, angiographic embolization, or surgical wedge resection of the lesion. We hope that the above video and discussion will help the ER and ICU doctor, nurses, paramedics and students in managing the patients more efficiently. You can always visit the website at https://regularcrisis.com #regularcrisis #Dieulafoylesion #uppergibleeding