Original Article
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Predictors of Rebleeding in Upper Gastrointestinal Dieulafoy Lesions
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Sang-Hun Park, Du-Hyeon Lee, Chang-Hwan Park, Jin Jeon, Ho-Jun Lee, Sung-Uk Lim, Seon-Young Park, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew
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Clin Endosc 2015;48(5):385-391. Published online September 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.5.385
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- Background/Aims
Dieulafoy lesions (DLs) are a rare but significant cause of upper gastrointestinal bleeding. We aimed to define the clinical significance of rebleeding and identify the predictors of rebleeding and mortality in upper gastrointestinal Dieulafoy lesions (UGIDLs).
MethodsPatients diagnosed with UGIDLs between January 2004 and June 2013 were retrospectively evaluated. Multivariate logistic regression analyses were performed to define the predictors of rebleeding and mortality in patients with UGIDLs.
ResultsThe study group consisted of 81 male and 36 female patients. Primary hemostasis was achieved in 115 out of 117 patients (98.3%) with various endoscopic therapies. Rebleeding occurred in 10 patients (8.5%). The mortality rate was significantly higher in patients with rebleeding than in those without rebleeding (30.0% vs. 4.7%, p=0.020). Multivariate logistic regression analysis revealed that kidney disease (p=0.006) and infection (p=0.005) were significant predictors of rebleeding in UGIDLs and that kidney disease (p=0.004) and platelet count (p=0.013) were significant predictors of mortality.
ConclusionsRebleeding has an important prognostic significance in patients with UGIDLs. Kidney disease and infection are major predictors of rebleeding and mortality in patients with UGIDLs.
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Citations
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- Clinical outcomes of Dieulafoy's lesion compared with peptic ulcer in upper gastrointestinal bleeding
Sang Yong Jo, Jin Hee Noh, Boram Cha, Ji Yong Ahn, Seung‐pyo Oh, Jun‐young Seo, Hee Kyong Na, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon‐Yong Jung
Journal of Gastroenterology and Hepatology.2023; 38(6): 888. CrossRef - Intragastric Single-Port Surgery: An Innovative and Multipurpose Technique for the Therapy of Upper Digestive Tract Lesions
Renjie Li, Wilfried Veltzke-Schlieker, Andreas Adler, Mahmoud Ismail, Harun Badakhshi, Ricardo Zorron
Surgical Innovation.2022; 29(1): 56. CrossRef - Outcomes in Severe Upper GI Hemorrhage from Dieulafoy’s Lesion with Monitoring of Arterial Blood Flow
B. Nulsen, D. M. Jensen, T. O. G. Kovacs, K. A. Ghassemi, M. Kaneshiro, G. S. Dulai, R. Jutabha, J. A. Gornbein
Digestive Diseases and Sciences.2021; 66(10): 3495. CrossRef - Hybrid surgical technologies in the treatment of patients with Dieulafoy’s lesion complicated by recurrent gastrointestinal bleeding
S.E. Voskanyan, M.V. Shabalin, A.I. Artemyev, I.Yu. Kolyshev, Z. Bogoevich, A.N. Bashkov, E.V. Naidenov
Endoskopicheskaya khirurgiya.2020; 26(1): 40. CrossRef - Dieulafoy Lesion: Predictive Factors of Early Relapse and Long-Term Follow-Up
Paulo Massinha, Inês Cunha, Luís Tomé
GE - Portuguese Journal of Gastroenterology.2020; 27(4): 237. CrossRef - A Rare Cause of Gastrointestinal Bleeding in a 65-Year-Old Man with History of Polycythemia Vera
Najmeh Aletaha, Hoda Hamid, Niloofar Ayoobi Yazdi, Reza Taslimi, Bijan Shahbazkhani, Pardis Ketabi Moghadam
Middle East Journal of Digestive Diseases.2019; 11(4): 225. CrossRef - Lesión de Dieulafoy en estómago como causa de sangrado gastrointestinal alto: presentación de un caso
Jairo Alonso Sierra-Avendaño, Fabián Andrés Mejía-Casadiegos, María Paula Pérez-Barón, Gabriel Eduardo Pérez-García
Revista Médicas UIS.2019; 32(1): 27. CrossRef - Endoscopic Management of Nonvariceal, Nonulcer Upper Gastrointestinal Bleeding
Michael A. Chang, Thomas J. Savides
Gastrointestinal Endoscopy Clinics of North America.2018; 28(3): 291. CrossRef - Refractory Gastric Hemorrhage from Caliber Persistent Arteries of the Left Inferior Phrenic Artery
Takahiro Hosoi, Norihiro Yuasa, Eiji Takeuchi, Hideo Miyake, Hidemasa Nagai, Yuichiro Yoshioka, Masataka Okuno, Takayuki Minami, Kanji Miyata, Masahiko Fujino
The Japanese Journal of Gastroenterological Surgery.2017; 50(2): 112. CrossRef
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Case Report
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Eosinophilic Gastroenteritis Due to Rhus Ingestion Presenting with Gastrointestinal Hemorrhage
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Wonsuk Choi, Seon-Young Park, Chan Choi, Kyuman Cho, Chang-Hwan Park, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew
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Clin Endosc 2015;48(2):174-177. Published online March 27, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.2.174
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Rhus-related illnesses in Korea are mostly caused by ingestion of parts of the Rhus tree. Contact dermatitis occurrence after ingestion of Rhus-related food is very common in Korea. However, Rhus-related gastrointestinal disease is very rare. Herein, we present a case of eosinophilic
gastroenteritis caused by Rhus ingestion. A 75-year-old woman was admitted with hematemesis and hematochezia after Rhus extract ingestion. Routine laboratory tests revealed leukocytosis without eosinophilia. Endoscopy showed friable and granular mucosal changes with touch bleeding in the second portion of the duodenum. Abdominal computed tomography revealed edematous wall thickening
of the duodenum and proximal jejunal loops. Patch testing with Rhus extracts showed a strong positive reaction, suggesting Rhus as the allergen. Her symptoms improved after avoidance of the allergen.
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Systemic contact dermatitis induced by
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Clinical and Experimental Dermatology.2021; 46(2): 324. CrossRef - Upper Gastrointestinal Bleeding as the First Presentation of Eosinophilic Gastrointestinal Disease
Elif Ozdogan, Latife Doganay Caglayan, Ozlem Mizikoglu, Cigdem Arikan
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Valentín Gonzalez-Canalizo, Nerea Segues, Andrea Medina, Silvia Torrente, Vanessa Aguilar-Gama, Paula Ortega, Luis Bujanda
Gastroenterología y Hepatología.2019; 42(5): 307. CrossRef - Severe upper gastrointestinal bleeding due to eosinophilic gastritis
Valentín Gonzalez-Canalizo, Nerea Segues, Andrea Medina, Silvia Torrente, Vanessa Aguilar-Gama, Paula Ortega, Luis Bujanda
Gastroenterología y Hepatología (English Edition).2019; 42(5): 307. CrossRef
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3
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4
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Focused Review Series: Endoscopic Management of Upper Gastrointestinal Bleeding
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Endoscopic Management of Mallory-Weiss Tearing
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Hyun-Soo Kim
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Clin Endosc 2015;48(2):102-105. Published online March 27, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.2.102
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Mallory-Weiss tearing (MWT) is a common cause of non-variceal upper gastrointestinal bleeding. Although the majority of patients with bleeding MWT require no intervention other than hemodynamic supports, spectrum of MWT is wide, and the condition sometimes results in a fatal outcome. Endoscopic management to stop the bleeding may be required during the index endoscopy, especially in those with active bleeding or stigmata of recurrent bleeding. Most commonly used endoscopic treatment for actively bleeding MWT is injection therapy, argon plasma coagulation, hemoclip placement, and band ligation. Selection of the optimal endoscopic hemostasis depends on the physician's ability and patient's clinical status.
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Joon Sung Kim, Byung-Wook Kim, Do Hoon Kim, Chan Hyuk Park, Hyuk Lee, Moon Kyung Joo, Da Hyun Jung, Jun-Won Chung, Hyuk Soon Choi, Gwang Ho Baik, Jeong Hoon Lee, Kyo Young Song, Saebeom Hur
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Kathleen Rich
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Reviews
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Korean Guidelines for Postpolypectomy Colonoscopy Surveillance
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Dong-Hoon Yang, Sung Noh Hong, Young-Ho Kim, Sung Pil Hong, Sung Jae Shin, Seong-Eun Kim, Bo In Lee, Suck-Ho Lee, Dong Il Park, Hyun-Soo Kim, Suk-Kyun Yang, Hyo Jong Kim, Se Hyung Kim, Hyun Jung Kim, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance and Management
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Clin Endosc 2012;45(1):44-61. Published online March 31, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.1.44
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Postpolypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. In this report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy and we elucidated the high risk findings of the index colonoscopy as follows: 3 or more adenomas, any adenoma larger than 10 mm, any tubulovillous or villous adenoma, any adenoma with high-grade dysplasia, and any serrated polyps larger than 10 mm. Surveillance colonoscopy should be performed five years after the index colonoscopy for those without any high-risk findings and three years after the index colonoscopy for those with one or more high risk findings. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polypectomy, the patient's general condition, and family and medical history.
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Korean Guidelines for Colorectal Cancer Screening and Polyp Detection
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Bo-In Lee, Sung Pil Hong, Seong-Eun Kim, Se Hyung Kim, Hyun-Soo Kim, Sung Noh Hong, Dong-Hoon Yang, Sung Jae Shin, Suck-Ho Lee, Dong Il Park, Young-Ho Kim, Hyun Jung Kim, Suk-Kyun Yang, Hyo Jong Kim, Hae Jeong Jeon, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance and Management
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Clin Endosc 2012;45(1):25-43. Published online March 31, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.1.25
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Abstract
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Now colorectal cancer is the second most common cancer in males and the fourth most common cancer in females in Korea. Since most of colorectal cancers occur after the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are one of the most effective methods to prevent colorectal cancer. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish Korean guideline for colorectal cancer screening and polyp detection. The guideline was developed by the Korean Multi-Society Take Force and we tried to establish the guideline by evidence-based methods. Parts of the statements were draw by systematic reviews and meta-analyses. Herein we discussed epidemiology of colorectal cancers and adenomas in Korea and optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.
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Korean Guideline for Colonoscopic Polypectomy
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Suck-Ho Lee, Sung Jae Shin, Dong Il Park, Seong-Eun Kim, Hae Jeong Jeon, Se Hyung Kim, Sung Pil Hong, Sung Noh Hong, Dong-Hoon Yang, Bo In Lee, Young-Ho Kim, Hyun-Soo Kim, Hyun Jung Kim, Suk-Kyun Yang, Hyo Jong Kim, Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance and Management
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Clin Endosc 2012;45(1):11-24. Published online March 31, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.1.11
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Abstract
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Supplementary Material
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There is indirect evidence to suggest that 80% of colorectal cancers (CRC) develop from adenomatous polyps and that, on average, it takes 10 years for a small polyp to transform into invasive CRC. In multiple cohort studies, colonoscopic polypectomy has been shown to significantly reduce the expected incidence of CRC by 76% to 90%. Colonoscopic polypectomy is performed frequently in primary outpatient clinics and secondary and tertiary medical centers in Korea. However, there are no evidence-based, procedural guidelines for the appropriate performance of this procedure, including the technical aspects. For the guideline presented here, PubMed, Medline, and Cochrane Library literature searches were performed. When little or no data from well-designed prospective trials were available, an emphasis was placed on the results from large series and reports from recognized experts. Thus, these guidelines for colonoscopic polypectomy are based on a critical review of the available data as well as expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data become available. This guideline is intended to be an educational device to provide information that may assist endoscopists in providing care to patients. This guideline is not a rule and should not be construed as a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment. Clinical decisions for any particular case involve a complex analysis of the patient's condition and the available courses of action.
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Chang Kyo Oh, Bo-In Lee, Sung Hak Lee, Seung-Jun Kim, Han Hee Lee, Chul-Hyun Lim, Jin Su Kim, Yu Kyung Cho, Jae Myung Park, Young-Seok Cho, In Seok Lee, Myung-Gyu Choi
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Original Articles
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Clinical Outcomes and Risk Factors of Rebleeding Following Endoscopic Therapy for Nonvariceal Upper Gastrointestinal Hemorrhage
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Ki Tae Suk, Hyun-Soo Kim, Chang Seob Lee, Il Young Lee, Moon Young Kim, Jae Woo Kim, Soon Koo Baik, Sang Ok Kwon, Dong Ki Lee, Young Lim Ham
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Clin Endosc 2011;44(2):93-100. Published online December 31, 2011
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DOI: https://doi.org/10.5946/ce.2011.44.2.93
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Abstract
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- Background/Aims
Rebleeding after endoscopic therapy for non-variceal upper gastrointestinal hemorrhage (NGIH) is the most important predictive factor of mortality. We evaluated the risk factors of rebleeding in patients undergoing endoscopic therapy for the NGIH.
MethodsBetween January 2003 and January 2007, 554 bleeding events in 487 patients who underwent endoscopic therapy for NGIH were retrospectively enrolled. We reviewed the clinicoendoscopical characteristics of patients with rebleeding and compared them with those of patients without rebleeding.
ResultsThe incidence of rebleeding was 21.7% (n=120). In the multivariate analysis, initial hemoglobin level ≤9 g/dL (p=0.002; odds ratio [OR], 2.433), inexperienced endoscopist with less than 2 years of experience in therapeutic endoscopy (p=0.001; OR, 2.418), the need for more 15 cc of epinephrine (p=0.001; OR, 2.570), injection therapy compared to thermal and injection therapy (p=0.001; OR, 2.840), and comorbidity with chronic renal disease (p=0.004; OR, 2.908) or liver cirrhosis (p=0.010; OR, 2.870) were risk factors for rebleeding following endoscopic therapy.
ConclusionsTogether with patients with low hemoglobin level at presentation, chronic renal disease, liver cirrhosis, the need for more 15 cc of epinephrine, or therapy done by inexperienced endoscopist were risk factors for the development of rebleeding.
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A Comparison of Clinical Characteristics between Medically-treated Patients and Surgically-treated Patients with Ischemic Colitis
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Nam-Chul Jin, Hyun-Soo Kim, Dae-Hyun Kim, Young-A Song, Yeon-Ju Kim, Tae-Jin Seo, Sun-Young Park, Chang-Hwan Park, Young-Eun Joo, Sung-Kyu Choi, Jong-Sun Rew
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Clin Endosc 2011;44(1):38-43. Published online September 30, 2011
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DOI: https://doi.org/10.5946/ce.2011.44.1.38
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Abstract
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- Background/Aims
Ischemic colitis (IC) is usually a self-limiting disease. But, it can cause necrosis that requires urgent surgical treatment. We sought to evaluate clinical difference in IC patients between medical and surgical treatment groups, and to identify prognostic factors for adverse outcomes.
MethodsWe conducted a retrospective analysis of clinical characteristics in patients with IC treated in Chonnam National University Hospital between May 2001 and April 2010. A total of 81 patients with IC were enrolled. We classified the patients into two groups-a medical treatment group and a surgical treatment group-and evaluated their clinical features, treatment outcomes and mortality.
ResultsAbsence of hematochezia, vomiting, abdominal tenderness, abdominal rebound tenderness, heart rate over 90 beats/min, systolic blood pressure less than 100 mm Hg, hyponatremia and increased LDH or serum creatinine level were observed more frequently in surgically-treated patients (p<0.05). Most cases in the medically-treated group resolved without complications (98.3%). But, about half of the cases (52.4%) of the surgically-treated group resolved and the mortality rate was 47.6%.
ConclusionsIn patients with ischemic colitis, several clinical factors are associated with surgical treatment. Although IC is often selflimited, our data suggests that special attention and aggressive therapy is warranted in treating these patients.
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Citations
Citations to this article as recorded by

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