Open AccessEndoscopic management of Dieulafoy’s lesion using Isoamyl-2-cyanoacrylate
Author(s) -
Abd Elrazek Abd Elrazek,
Yoko Nakamura,
Hiroki Moriguchi,
M. T. Afify,
Mohamed Mamdouh Asar,
Badr Ismael,
Magdy Salah
Publication year - 2013
Publication title -
world journal of gastrointestinal endoscopy
Language(s) - English
Resource type - Journals
ISSN - 1948-5190
DOI - 10.4253/wjge.v5.i8.417
Subject(s) - medicine , cyanoacrylate , lesion , therapeutic endoscopy , sclerotherapy , endoscopy , surgery , varices , gastrointestinal bleeding , radiology , gastroenterology , cirrhosis , chemistry , adhesive , organic chemistry , layer (electronics)
Dieulafoy's lesion (DL) is a rare but important cause of obscure gastrointestinal bleeding that may be overlooked during diagnostic endoscopy. Mortality rates are similar to those of other causes for gastrointestinal bleeding. Diagnosis by upper endoscopy is the modality 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, endoscopist 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 gastrointestinal lesion is suspected. Cyanoacryltes compounds 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.