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Digestive Diseases and Sciences

, Volume 41, Issue 12, pp 2348–2352 | Cite as

Diagnostic efficacy of push-enteroscopy and long-term follow-up of patients with small bowel angiodysplasias

  • Alain Schmit
  • France Gay
  • Michael Adler
  • Michel Cremer
  • André van Gossum
Diagnostic And Interventional Techniques

Abstract

Gastrointestinal angiodysplasias are the most common cause of obscure chronic digestive blood loss. Push-enteroscopy is likely to detect and to treat vascular lesions. Push-enteroscopy was performed in 83 patients (mean age 62 years) presenting with iron deficiency anemia of obscure origin. A nonrevealing preliminary evaluation included esophagogastroduodenoscopy, colonoscopy and, in 50% of the patients, small bowel barium studies. We employed a 240-cm Olympus push-enteroscope (XSIF-100), 11.3 mm in diameter. A potential bleeding lesion was observed in 49 patients (59%). Gastrointestinal angiodysplasias were the most common lesion (33 patients). Electrocoagulation (bicap) of angiodysplasias was performed when accessible and not diffuse (<20). If not contraindicated, hormonal treatment was proposed for patients who had at least five AD. Some patients had both treatments. Long-term follow-up (mean, 12.2 months) was obtained in 25 patients with small bowel angiodysplasias. A good outcome (neither recurrence of anemia nor blood transfusion requirements) was observed in 12 patients. The diagnostic efficacy of push-enteroscopy is high. Despite available and recommended therapeutic modalities, the long-term outcome was considered to be good in only 50% of the patients.

Key words

anemia angiodysplasia small bowel enteroscopy digestive bleeding 

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Copyright information

© Plenum Publishing Corporation 1996

Authors and Affiliations

  • Alain Schmit
    • 1
  • France Gay
    • 1
  • Michael Adler
    • 1
  • Michel Cremer
    • 1
  • André van Gossum
    • 1
  1. 1.From the Departments of Gastroenterology and HepaticopancreatologyErasme University HospitalBrusselsBelgium

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