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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.

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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

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