gestodene and Melena

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.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Angiodysplasia; Combined Modality Therapy; Drug Therapy, Combination; Electrocoagulation; Endoscopy, Gastrointestinal; Ethinyl Estradiol; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Humans; Intestinal Diseases; Intestine, Small; Male; Melena; Middle Aged; Norethindrone; Norethindrone Acetate; Norpregnenes; Progesterone Congeners; Retrospective Studies; Treatment Outcome