Endoscopic treatment of Dieulafoy's disease

Abstract

The “exulceratio simplex Dieulafoy” is an uncommon and dangerous cause of upper gastrointestinal hemorrhage. In all patients admitted to our hospital with signs of acute gastrointestinal hemorrhage in whom Dieulafoy's disease was diagnosed at emergency endoscopy, an attempt was made to stop the bleeding or to prevent further hemorrhage by local injection of polidocanol, or by bipolar electrocoagulation, or by a combination of both. Since 1979 an exulceratio simplex has been diagnosed in 22 patients. All patients were treated endoscopically, 18 of them with satisfactory results. Four patients had to be operated on after emergency endoscopy had failed. Knowing the location of the bleeding site, the operations could be planned exactly and performed quickly. All patients, whether they had undergone endoscopic or surgical treatment, made an uncomplicated recovery and none had a further bleeding episode after discharge from the hospital.