PUSH ENTEROSCOPIC CAUTERIZATION - LONG-TERM FOLLOW-UP OF 83 PATIENTS WITH BLEEDING SMALL-INTESTINAL ANGIODYSPLASIA

Background: This study assessed the long-term effectiveness of push en teroscopic cauterization of bleeding intestinal angiodysplasia. Method s: We retrospectively reviewed the clinical course of patients who und erwent push and sonde enteroscopy for obscure gastrointestinal bleedin g and were diagnosed with intestinal angiodysplasias. Results: One hun dred twelve patients bleeding from small intestinal angiodysplasias we re identified. After excluding those lost to follow-up (29), data were collected from 83 patients. Fifty-five patients (29 men; mean age, 73 years; mean units of packed red blood cells transfused, 21.4; average bleeding history, 22 months) were cauterized. Twenty-eight patients ( 12 men; mean age, 71; mean units of packed red blood cells transfused, 15.8; average bleeding history, 22 months) were not cauterized. The n oncauterized group (follow-up, 26 +/- 14 months; mean +/- SD) continue d to bleed, requiring 2.16 +/- 3.86 units of packed red blood cells tr ansfused per month (units/month) before and 0.97 +/- 1.46 units/month after diagnosis (NS). The cauterized group (follow-up, 30 +/- 18 month s) significantly improved, requiring 2.40 +/- 2.97 units/month before treatment and 0.32 +/- 0.91 units/month after cauterization (p < 0.000 1, paired t test). Conclusion: Cauterization of endoscopically accessi ble small intestinal angiodysplasias may decrease rebleeding.