Risk Factors for Rebleeding after Emergency Endoscopic Treatment of Dieulafoy Lesion
Background and Objective: Dieulafoy lesion is a rare, but life-threatening, cause of gastrointestinal hemorrhage, and endoscopic therapy is the preferred first-line treatment. The present study aims to analyze the risk factors for rebleeding after endoscopic hemostasis of gastroduodenal Dieulafoy le...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2020/2385214 |
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| author | Yongkang Lai Jianfang Rong Zhenhua Zhu Wangdi Liao Bimin Li Yin Zhu Youxiang Chen Xu Shu |
| author_facet | Yongkang Lai Jianfang Rong Zhenhua Zhu Wangdi Liao Bimin Li Yin Zhu Youxiang Chen Xu Shu |
| author_sort | Yongkang Lai |
| collection | DOAJ |
| description | Background and Objective: Dieulafoy lesion is a rare, but life-threatening, cause of gastrointestinal hemorrhage, and endoscopic therapy is the preferred first-line treatment. The present study aims to analyze the risk factors for rebleeding after endoscopic hemostasis of gastroduodenal Dieulafoy lesion. Methods. A retrospective review of patients with Dieulafoy lesion who developed acute gastrointestinal bleeding and were treated primarily with endoscopic therapy from September 2014 to April 2019 was conducted. Results. A total of 133 patients with Dieulafoy lesion were included in the present study. The mean age of these patients was 56.05 ± 16.58 years, and 115 patients were male. Among these 133 patients, 26 patients developed rebleeding within 30 days of endoscopic therapy. The 30-day rebleeding rate for pure injection therapy (epinephrine, cyanoacrylate, or lauromacrogol injection alone), nonpure injection therapy (argon plasma coagulation, band ligation, and hemoclip application alone), and combination therapy (combination of any >2 methods) was 45.2%, 12.8%, and 11%, respectively. In the univariable analysis, endoscopic treatment, prothrombin time, gender, Rockall score, and leukocyte count were the risk factors for rebleeding. In the multivariable analysis, pure injection endoscopic treatment, white blood cells (>10 × 109/L), and prothrombin time >12 seconds were the independent risk factors for rebleeding. Conclusion. Patients who undergo pure injection endoscopic treatment and have a high leukocyte count (>10 × 109/L) or elevated prothrombin time (>12 seconds) have an increased risk of rebleeding within 30 days after endoscopic treatment for gastroduodenal Dieulafoy lesion. Combined endoscopic treatment is the most effective therapy to prevent rebleeding in gastroduodenal Dieulafoy lesion. |
| format | Article |
| id | doaj-art-121aa625c7774de1b773cfc1a096d2cb |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-121aa625c7774de1b773cfc1a096d2cb2025-02-03T01:04:23ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972020-01-01202010.1155/2020/23852142385214Risk Factors for Rebleeding after Emergency Endoscopic Treatment of Dieulafoy LesionYongkang Lai0Jianfang Rong1Zhenhua Zhu2Wangdi Liao3Bimin Li4Yin Zhu5Youxiang Chen6Xu Shu7Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, ChinaDepartment of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, ChinaBackground and Objective: Dieulafoy lesion is a rare, but life-threatening, cause of gastrointestinal hemorrhage, and endoscopic therapy is the preferred first-line treatment. The present study aims to analyze the risk factors for rebleeding after endoscopic hemostasis of gastroduodenal Dieulafoy lesion. Methods. A retrospective review of patients with Dieulafoy lesion who developed acute gastrointestinal bleeding and were treated primarily with endoscopic therapy from September 2014 to April 2019 was conducted. Results. A total of 133 patients with Dieulafoy lesion were included in the present study. The mean age of these patients was 56.05 ± 16.58 years, and 115 patients were male. Among these 133 patients, 26 patients developed rebleeding within 30 days of endoscopic therapy. The 30-day rebleeding rate for pure injection therapy (epinephrine, cyanoacrylate, or lauromacrogol injection alone), nonpure injection therapy (argon plasma coagulation, band ligation, and hemoclip application alone), and combination therapy (combination of any >2 methods) was 45.2%, 12.8%, and 11%, respectively. In the univariable analysis, endoscopic treatment, prothrombin time, gender, Rockall score, and leukocyte count were the risk factors for rebleeding. In the multivariable analysis, pure injection endoscopic treatment, white blood cells (>10 × 109/L), and prothrombin time >12 seconds were the independent risk factors for rebleeding. Conclusion. Patients who undergo pure injection endoscopic treatment and have a high leukocyte count (>10 × 109/L) or elevated prothrombin time (>12 seconds) have an increased risk of rebleeding within 30 days after endoscopic treatment for gastroduodenal Dieulafoy lesion. Combined endoscopic treatment is the most effective therapy to prevent rebleeding in gastroduodenal Dieulafoy lesion.http://dx.doi.org/10.1155/2020/2385214 |
| spellingShingle | Yongkang Lai Jianfang Rong Zhenhua Zhu Wangdi Liao Bimin Li Yin Zhu Youxiang Chen Xu Shu Risk Factors for Rebleeding after Emergency Endoscopic Treatment of Dieulafoy Lesion Canadian Journal of Gastroenterology and Hepatology |
| title | Risk Factors for Rebleeding after Emergency Endoscopic Treatment of Dieulafoy Lesion |
| title_full | Risk Factors for Rebleeding after Emergency Endoscopic Treatment of Dieulafoy Lesion |
| title_fullStr | Risk Factors for Rebleeding after Emergency Endoscopic Treatment of Dieulafoy Lesion |
| title_full_unstemmed | Risk Factors for Rebleeding after Emergency Endoscopic Treatment of Dieulafoy Lesion |
| title_short | Risk Factors for Rebleeding after Emergency Endoscopic Treatment of Dieulafoy Lesion |
| title_sort | risk factors for rebleeding after emergency endoscopic treatment of dieulafoy lesion |
| url | http://dx.doi.org/10.1155/2020/2385214 |
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