[Endoscopic sclerotherapy is useful in Dieulafoy's disease ]. 1996

J A Ortuño-Cortés, and L Quintana-Tomás, and A García-García
Unidad de Gastroenterologia, Hospital General de Area de Elda, Alicante.

The clinical histories of 14 patients with digestive hemorrhage due to Dieulafoy disease admitted to the authors' hospital over 74 months were retrospectively analyzed. These cases represent 1.18% of the non varicose upper digestive hemorrhages (CI 95%; 0.57-1.79%). Male predominance (6:1) and advanced age (median: 67.5 years) were observed. The ingestion of potentially gastroerosive drugs, smoking and alcoholism were reported in 57, 57 and 7% of the cases, respectively. Six patients (43%) required more than one endoscopy for diagnosis. The lesion responsible for hemorrhage was found at 6 cm or less from the cardias on 11 occasions (78%). Endoscopic sclerotherapy was performed in the vessel by polidocanol at 2% (1.5-10 ml, median: 6). In 10 cases sclerotherapy was preceded by the injection of adrenaline 1/10,000 (2-11 ml, median: 5). Definitive hemostasis was achieved in 11 patients (78%) (two of these cases required further sclerotherapy); 2 patients required surgery, and one patient (7%) died. Of the 13 surviving patients, none presented relapse after follow up of 2-63 months. We can conclude that Dieulafoy disease is an infrequent but severe cause of digestive hemorrhage, being predominantly found in males over the age of 50 years. Repeated endoscopy is often required to determine diagnosis and treatment. Endoscopic sclerotherapy with polidocanol is effective and safe in this disease although surgery may be required and death may occur.

UI MeSH Term Description Entries
D007413 Intestinal Mucosa Lining of the INTESTINES, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. In the SMALL INTESTINE, the mucosa is characterized by a series of folds and abundance of absorptive cells (ENTEROCYTES) with MICROVILLI. Intestinal Epithelium,Intestinal Glands,Epithelium, Intestinal,Gland, Intestinal,Glands, Intestinal,Intestinal Gland,Mucosa, Intestinal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011092 Polyethylene Glycols Polymers of ETHYLENE OXIDE and water, and their ethers. They vary in consistency from liquid to solid depending on the molecular weight indicated by a number following the name. They are used as SURFACTANTS, dispersing agents, solvents, ointment and suppository bases, vehicles, and tablet excipients. Some specific groups are NONOXYNOLS, OCTOXYNOLS, and POLOXAMERS. Macrogols,Polyoxyethylenes,Carbowax,Macrogol,Polyethylene Glycol,Polyethylene Oxide,Polyethyleneoxide,Polyglycol,Glycol, Polyethylene,Glycols, Polyethylene,Oxide, Polyethylene,Oxides, Polyethylene,Polyethylene Oxides,Polyethyleneoxides,Polyglycols,Polyoxyethylene
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077423 Polidocanol An alkyl polyglycol ether of LAURYL ALCOHOL, chemically defined as an alcohol ethoxylate having an average alkyl chain of 12–14 carbon atoms, and an ethylene oxide chain of 9 ethylene oxide units. It is used as a detergent, and medically as a local anesthetic, and as a sclerosing agent for the treatment of ESOPHAGEAL AND GASTRIC VARICES and VARICOSE VEINS. Aethoxysclerol,Aethoxysklerol,Aetoxisclerol,Atossisclerol,Atoxysclerol,Brij 30,Brij-30,Dodecyl Ethyleneglycol Monoether,Ethoxysclerol,Hydroxypolyethoxydodecane,Laureth,Laureth 9,Laureth-1,Laureth-4,Laureth-7,Laureth-9,Lauromacrogol,Lauromacrogol 400,Lauromacrogols,Lubrol 12A9,Lubrol-PX,Nonaethylene Glycol Monododecyl Ether,Nonaethyleneglycol Monododecyl Ether,Polyethylene Glycol Monododecyl Ether,Polyethylene Glycol-7-lauryl Ether,Polyoxyethylene 9-lauryl Ether,Polyoxyethylene Lauryl Ether,Polyoxyethylene(4) Lauryl Ether,Polyoxyethylene-4-dodecyl Ether,Polyoxyethylenedodecyl Ether,Tetraethylene Glycol Dodecyl Ether,Tetraethyleneglycol Lauryl Ether,Thesit,alpha-Dodecyl-omega-hydroxypoly(oxy-1,2ethanediyl),Brij30,Dodecyl Ethyleneglycol Monoethers,Ether, Nonaethyleneglycol Monododecyl,Ether, Polyethylene Glycol-7-lauryl,Ether, Polyoxyethylene 9-lauryl,Ether, Polyoxyethylene Lauryl,Ether, Polyoxyethylene-4-dodecyl,Ether, Tetraethyleneglycol Lauryl,Ethyleneglycol Monoether, Dodecyl,Laureth 1,Laureth 4,Laureth 7,Laureths,Lauryl Ether, Tetraethyleneglycol,Lubrol PX,Monododecyl Ether, Nonaethyleneglycol,Monoether, Dodecyl Ethyleneglycol,Nonaethyleneglycol Monododecyl Ethers,Polidocanols,Polyethylene Glycol 7 lauryl Ether,Polyethylene Glycol-7-lauryl Ethers,Polyoxyethylene 4 dodecyl Ether,Polyoxyethylene 9 lauryl Ether,Polyoxyethylene 9-lauryl Ethers,Polyoxyethylene Lauryl Ethers,Polyoxyethylenedodecyl Ethers,Tetraethyleneglycol Lauryl Ethers

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