Current views on the etiology, pathogenesis, diagnosis and treatment of Dieulafoy syndrome (review of literature)

Abstract

The article is devoted to Dieulafoy syndrome, a rare pathology that manifests itself by intense bleeding from a defect of abnormally dilated vessels of the submucosal layer of the stomach. The article discusses the main methods of diagnosis, treatment and prevention of Dieulafoy syndrome, lists the synonyms of «Dieulafoy syndrome». A brief historical reference is given. The definition of the concept of «Dieulafoy syndrome» is given. The age and gender prevalence of this syndrome is analyzed. Variants of localization of the lesion in this syndrome are described. The main causes and risk factors for the occurrence of Dieulafoy syndrome are highlighted. The most common clinical manifestations are characterized. The advantages and disadvantages of various methods of diagnosis of Dieulafoy syndrome are described. Special attention is paid to the diagnosis and criteria for endoscopic verification of this syndrome. Various methods of treatment have been investigated: conservative, endoscopic and operative. The indications and contraindications to each of the treatment methods are described, as well as their advantages and disadvantages. Possible combinations of various methods of endoscopic hemostasis are listed. The question of choosing the optimal combination of different methods of endoscopic hemostasis is highlighted. Risk factors for recurrence of bleeding have been determined. The frequency of recurrence of bleeding in Dieulafoy syndrome was analyzed. A number of unresolved issues related to the diagnosis and treatment of this syndrome have been identified, such as issues of effective prevention and prediction of recurrent bleeding.