All are true about Dieulafoy's lesion except:
Ans. (a) Angiographic embolization is the preferred treatmentRef: Sabiston 19th Edition, Page 1168* Dieulafoy's lesion is most common in lesser curve near cardia (6cm from OG junction)* Dilated tortuous artery bleeding in submucosa (It is a branch from left gastric Artery)* Painless massive hemorrhage occurs* Treatment Protocol:# 1st - Endoscopic sclerosant and thermal therapy is tried first. Mostly it seems successful in 80% to 100% cases.# 2nd - Angiographic embolization with coils done if step 1 fails.# 3rd - Final step gastric wedge resection with bleeding vessel.
Angiographic embolization is the preferred treatment
Endoscopic treatment can be given
Pulsation of artery causes ulceration
Submucosal artery
Stomach & Duodenum