Mortality and rebleeding rate of Dieulafoy lesions throughout the gastrointestinal tract

Background/Objectives: Dieulafoy lesion (DL) is a rare yet potentially life-threatening cause of gastrointestinal bleeding. This study retrospectively analyzed all patients diagnosed with DL over the past two decades, focusing on clinical outcomes such as rebleeding and mortality. We aimed to identify factors associated with these outcomes to improve the understanding and management of this condition.

Materials/Methods: This study included 39 hospitalized patients who underwent endoscopy for gastrointestinal bleeding and were diagnosed with Dieulafoy lesions. Data were collected retrospectively, and regression analysis was performed to assess factors associated with all-cause mortality and rebleeding rates.

Results: The study included 39 patients, with a mean age of 64 years; 13 (33%) were women. The most common presenting complaint was hematemesis (41%). The most common localization of DLs was the stomach, with 25 (64.1%) DLs detected. Rebleeding rates within one week and mortality within 90 days were 33% and 28%, respectively. In univariate analysis, esophageal localization (HR: 3.398, p = 0.042), low hemoglobin levels (HR: 0.758, p = 0.030), and high Glasgow- Blatchford score (HR: 1.179, p = 0.035) were associated with rebleeding. Duodenal localization was independently associated with higher mortality (HR: 27.276, p < 0.001), after adjusting for age, sex, and comorbidity index.

Conclusion: Dieulafoy lesions are most commonly found in the stomach but can also occur in atypical sites like the jejunum or hernia pouch. Enteroscopy is crucial for diagnosing and treating DLs, especially those in atypical small intestine locations. Lesion localization plays a key role in predicting both rebleeding and mortality rates.

Keywords: dieulafoy lesion, duodenum, enteroscopy, esophagus, localisation.