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.
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Authors | A Schmit, F Gay, M Adler, M Cremer, A Van Gossum |
Journal | Digestive diseases and sciences
(Dig Dis Sci)
Vol. 41
Issue 12
Pg. 2348-52
(Dec 1996)
ISSN: 0163-2116 [Print] United States |
PMID | 9011441
(Publication Type: Journal Article)
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Chemical References |
- Norpregnenes
- Progesterone Congeners
- Gestodene
- Ethinyl Estradiol
- Norethindrone Acetate
- Norethindrone
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Angiodysplasia
(diagnosis, therapy)
- Combined Modality Therapy
- Drug Therapy, Combination
- Electrocoagulation
- Endoscopy, Gastrointestinal
(methods)
- Ethinyl Estradiol
(administration & dosage)
- Female
- Follow-Up Studies
- Gastrointestinal Hemorrhage
(etiology)
- Humans
- Intestinal Diseases
(diagnosis, therapy)
- Intestine, Small
- Male
- Melena
(etiology)
- Middle Aged
- Norethindrone
(administration & dosage, analogs & derivatives)
- Norethindrone Acetate
- Norpregnenes
(administration & dosage)
- Progesterone Congeners
(administration & dosage)
- Retrospective Studies
- Treatment Outcome
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