DIAGNOSTIC EFFICACY OF PUSH-ENTEROSCOPY AND LONG-TERM FOLLOW-UP OF PATIENTS WITH SMALL-BOWEL ANGIODYSPLASIAS

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 patie nts (mean age 62 years) presenting with iron deficiency anemia of obsc ure origin. A nonrevealing preliminary evaluation included esophagogas troduodenoscopy, colonoscopy and, in 50% of the patients, small bowel barium studies. We employed a 240-cm Olympus push-enteroscope (XSIF-10 0), 11.3 mm in diameter. A potential bleeding lesion was observed in 4 9 patients (59%). Gastrointestinal angiodysplasias were the most commo n lesion (33 patients). Electrocoagulation (bicap) of angiodysplasias was performed when accessible and not diffuse (< 20). If not contraind icated, 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 angiodyspla sias. A good outcome (neither recurrence of anemia nor blood transfusi on requirements) was observed in 12 patients. The diagnostic efficacy of push-enteroscopy is high. Despite available and recommended therape utic modalities, the long-term outcome was considered to be good in on ly 50% of the patients.