Outcomes of endoscopic treatment of gastroduodenal Dieulafoy's lesion with XXXX and thermal/injection therapy.

@entity1 @entity548 @entity75 @entity1425 @entity2144 @entity281 @entity3851 @entity583 @entity360
BACKGROUND: @entity75 is a rare but important cause of @entity360 . Current endoscopic methods used to treat @entity75 include injection, with or without thermal methods, and mechanical methods. The latter include variceal ligation and hemoclips. There are no studies comparing the outcomes of @entity2144 and injection with or without thermal therapy. AIM: To report the outcomes of @entity75 treated endoscopically with @entity2144 and injection with or without thermal therapy at a single institution. METHODS: @entity1 with the diagnosis of @entity75 treated endoscopically at the Carl T. Hayden VA Medical Center in Phoenix, between August 1994 and August 2002 were analyzed. Demographic data, mode of presentation, risk factors for @entity360 , hemodynamic parameters, blood transfusion requirements, endoscopic findings, details of endoscopic therapy, length of stay in ICU/hospital, complications, recurrence of @entity548 , and mortality rates were collected and compared between those receiving endoscopic band ligation (EBL group) and those receiving injection with or without thermal therapy (non-EBL group). RESULTS: Twenty-three @entity1 with @entity75 (14 in the EBL group and nine in the non-EBL group) were studied. All @entity1 were @entity1 . The mean age, hemoglobin levels on admission, and the transfusion requirements before therapy were similar in both groups. Fourteen @entity1 (eight in the EBL- and six in the non-EBL groups) presented with hematemesis and the remaining with melena. The majority of @entity75 (91.3%) were located in the stomach and two in the duodenum. Active @entity548 at the time of endoscopy was seen in 61% of cases, and immediate hemostasis was achieved with either method in 100% of @entity1 . Early rebleeding (within 72 hours of endoscopic therapy) occurred in only one @entity1 treated with @entity1425 plus heater probe therapy. The length of stay in ICU was longer in the non-EBL group (6.7 days) compared with the EBL group (1.8 days) (P = 0.2). There were six deaths (three in the non-EBL group and three in the EBL group) within 30 days of the index hospitalization. The causes of death included @entity281 (n = 3), complications of @entity583 (n = 2), and @entity3851 (n = 1). CONCLUSIONS: Endoscopic @entity2144 is as effective as injection with or without thermal therapy in the treatment of @entity75 .
