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Korean J Gastrointest Endosc > Volume 32(3); 2006 > Article
Korean Journal of Gastrointestinal Endoscopy 2006;32(3): 168-172.
출혈성 Dieulafoy 병변의 내시경 치료에서 체위변화의 유용성
이재학·이석호·배원엽·박정훈·박도현·정일권·박상흠·김선주
순천향대학교 의과대학 천안병원 소화기내과
The Usefulness of Positional Change in Endoscopic Hemostasis for Bleeding Dieulafoy's Lesion
Jae Hak Lee, M.D., Suck Ho Lee, M.D., Won Yeop Bae, M.D., Jeong Hoon Park, M.D., Do Hyun Park, M.D., Il Kwun Chung, M.D., Sang Heum Park, M.D. and Sun Joo Kim, M.D.
Division of Gastroenterology, Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
Abstract

Background/Aims:
Dieulafoy's lesion is a rare cause of massive upper gastrointestinal bleeding, most commonly in the proximal stomach. Although the mechanical hemostatic method has been widely used, it is difficult to access for complete application. This study evaluated the utility of a positional change in patients with a bleeding Dieulafoy's lesion.
Methods:
Between January 2003 and March 2004, 15 patients with a bleeding Dieulafoy's lesion were randomly assigned to either a positional change group (right decubitus or supine, n=7) or a left decubitus group (n=8). The demographic characteristics, endoscopic variables, and clinical outcomes were analyzed.
Results:
The patients' characteristics at entry were similar in both groups. Initial hemostasis was achieved in all patients. Recurrent bleeding developed in only one patients in the left decubitus group. The mean procedure time was significantly shorter in the positional change group than in the left decubitus group (4.5⁑3.4 min vs. 7.4⁑5.2 min, p<0.05). The ineffective hemoclip number (respectively, 0.3⁑0.1 vs. 1.4⁑1.2, p<0.05) was significantly different in the two groups. No major procedure-related complications occurred in the positional change group.
Conclusions:
Endoscopic hemostasis with a positional change is an effective and safe method for treating in a bleeding Dieulafoy's lesion. (Korean J Gastrointest Endosc 2006; 32:168⁣172)
Key Words: Dieulafoy's lesion, Endoscopic hemostasis, Positional change
주요어: Dieulafoy 병변, 내시경 지혈술, 체위변화
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