Endoscopy 2005; 37(4): 401-402
DOI: 10.1055/s-2005-861092
Letter to the Editor
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Identification of a Gastric Dieulafoy’s Lesion Following Ephedrine Administration

E.  Brullet1 , F.  Junquera1 , R.  Campo1 , A.  B. Ortega1 , J.  Troy1
  • 1Endoscopy Unit, Sabadell Hospital, Parc Taulí, Sabadell, Spain
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Publication History

Publication Date:
12 April 2005 (online)

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Introduction

The diagnosis of Dieulafoy’s lesions may be difficult even for experienced endoscopists [1]. Nearly one-third of patients who have bleeding from Dieulafoy’s lesions require repeated endoscopic examinations before a conclusive diagnosis can be reached [2]. Failure to diagnose this condition is mainly due to the absence of active bleeding or stigmata of recent hemorrhage during endoscopy (bleeding from Dieulafoy’s lesions is often intermittent) [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13]. This report describes a case in which on two occasions, the administration of ephedrine to treat propofol-induced hypotension during gastroscopy was followed by the appearance of active bleeding from a gastric Dieulafoy’s lesion that had not been identified on previous endoscopic and angiographic studies. This allowed endoscopic diagnosis of the Dieulafoy’s lesion and successful treatment by elastic band ligation.

References

E. Brullet, M. D.

Endoscopy Unit
Hospital de Sabadell
Corporació Parc Taulí
Parc Taulí s/n

08208 Sabadell
Spain

Fax: +34-93-7236187

Email: ebrullet@cspt.es