BACKGROUND: The investigation of iron-deficiency anaemia is often inadequate. Synchronous upper and lower gastrointestinal endoscopy under the same sedative episode (bidirectional endoscopy; BDE) has been proposed for all such patients. METHODS: The value of this strategy has been examined prospectively. Eighty-nine patients with iron-deficiency anaemia underwent BDE using local anaesthesia of the throat and intravenous midazolam. RESULTS: A cause for gastrointestinal blood loss was found in 75 patients (84 per cent) after BDE alone. Twenty-five patients (28 per cent) had upper gastrointestinal pathology alone, 24 (27 per cent) had lower gastrointestinal pathology alone and 26 (29 per cent) had dual pathology. Forty-five patients (51 per cent) had gastrointestinal malignancy. Twenty patients (22 per cent) had further investigations and these yielded a diagnosis in five. No cause for the anaemia was found in nine patients (10 per cent). Treatment of the bleeding source(s) resolved the anaemia in all but one patient. CONCLUSION: BDE is an effective investigation for patients with iron-deficiency anaemia and its use should be encouraged.
BACKGROUND: The investigation of iron-deficiency anaemia is often inadequate. Synchronous upper and lower gastrointestinal endoscopy under the same sedative episode (bidirectional endoscopy; BDE) has been proposed for all such patients. METHODS: The value of this strategy has been examined prospectively. Eighty-nine patients with iron-deficiency anaemia underwent BDE using local anaesthesia of the throat and intravenous midazolam. RESULTS: A cause for gastrointestinal blood loss was found in 75 patients (84 per cent) after BDE alone. Twenty-five patients (28 per cent) had upper gastrointestinal pathology alone, 24 (27 per cent) had lower gastrointestinal pathology alone and 26 (29 per cent) had dual pathology. Forty-five patients (51 per cent) had gastrointestinal malignancy. Twenty patients (22 per cent) had further investigations and these yielded a diagnosis in five. No cause for the anaemia was found in nine patients (10 per cent). Treatment of the bleeding source(s) resolved the anaemia in all but one patient. CONCLUSION:BDE is an effective investigation for patients with iron-deficiency anaemia and its use should be encouraged.
Authors: William G Paterson; William T Depew; Pierre Paré; Denis Petrunia; Connie Switzer; Sander J Veldhuyzen van Zanten; Sandra Daniels Journal: Can J Gastroenterol Date: 2006-06 Impact factor: 3.522
Authors: Mark Hong Lee; Eugene Park; Jongchan Lee; So Young Kim; Sung Yong Kim; Sun Young Lee; Yo Han Cho; So Young Yoon Journal: Int J Hematol Date: 2012-06-28 Impact factor: 2.490
Authors: Ja Sung Choi; Young Hoon Youn; Sang Kil Lee; Jin Yi Choi; Hee Man Kim; Yu Jin Kim; Ki Jun Han; Hyeon Geun Cho; Si Young Song; Jae Hee Cho Journal: Surg Endosc Date: 2013-01-26 Impact factor: 4.584