Diagnostic efficacy of push-enteroscopy and long-term follow-up of patients with small bowel angiodysplasias
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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 wordsanemia angiodysplasia small bowel enteroscopy digestive bleeding
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- 10.Van Cutsem E, Rutgeerts P, Van Trappen G: Treatment of bleeding gastrointestinal vascular malformations with oestrogen-progesterone. Lancet 335:935–954, 1990Google Scholar
- 14.Croquenec B, Canard JM, Houcke Ph, Gay G, Lapuelle J, Marchetti B, Pujol B, Delmotte JS: Vidéo entéroscopie poussée par double voie (V.E.P.) premier bilan (269 cas). Gastroentérol Clin Biol 19(2):A17, 1995 (abstract)Google Scholar
- 15.Bitoun A, Bouhnik Y, Oudghiri A, Coffin B, Thérond JP, Vernisse B, Moussaoui R, Rambaud JC: Entéroscopie poussée (EP) par double voie: Expérience chez 62 patients consécutifs (abstract). Gastroentérol Clin Biol 19(2):A145, 1995 (abstract)Google Scholar
- 20.Lewis B, Rivera-MacMurray S, Kornbluth A, Salomon P, Waye J: Hormonal therapy for chronic GI bleeding from diffuse small bowel angiodysplasia—the results of a controlled trial in 56 patients. Am J Gastroenterol 85(7–12):1266 (A204), 1990 (abstract)Google Scholar