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

Dig Dis Sci. 1996 Dec;41(12):2348-52. doi: 10.1007/BF02100126.

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiodysplasia / diagnosis*
  • Angiodysplasia / 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
  • Intestinal Diseases / therapy
  • Intestine, Small*
  • Male
  • Melena / etiology
  • Middle Aged
  • Norethindrone / administration & dosage
  • Norethindrone / analogs & derivatives
  • Norethindrone Acetate
  • Norpregnenes / administration & dosage
  • Progesterone Congeners / administration & dosage
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Norpregnenes
  • Progesterone Congeners
  • Gestodene
  • Ethinyl Estradiol
  • Norethindrone Acetate
  • Norethindrone