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

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.
AuthorsA Schmit, F Gay, M Adler, M Cremer, A Van Gossum
JournalDigestive diseases and sciences (Dig Dis Sci) Vol. 41 Issue 12 Pg. 2348-52 (Dec 1996) ISSN: 0163-2116 [Print] United States
PMID9011441 (Publication Type: Journal Article)
Chemical References
  • Norpregnenes
  • Progesterone Congeners
  • Gestodene
  • Ethinyl Estradiol
  • Norethindrone Acetate
  • Norethindrone
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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