All are true about Dieulafoy's lesion except:: (A) Angiographic embolization is the preferred treatment, (B) Endoscopic treatment can be given, (C) Pulsation of artery causes ulceration, (D) Submucosal artery
Answer is A. 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.