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 enteroscopic cauterization of bleeding intestinal angiodysplasia.


METHODS
We retrospectively reviewed the clinical course of patients who underwent push and sonde enteroscopy for obscure gastrointestinal bleeding and were diagnosed with intestinal angiodysplasias.


RESULTS
One hundred twelve patients bleeding from small intestinal angiodysplasias were 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 noncauterized group (follow-up, 26 +/- 14 months; mean +/- SD) continued to bleed, requiring 2.16 +/- 3.86 units of packed red blood cells transfused per month (units/month) before and 0.97 +/- 1.46 units/month after diagnosis (NS). The cauterized group (follow-up, 30 +/- 18 months) significantly improved, requiring 2.40 +/- 2.97 units/month before treatment and 0.32 +/- 0.91 units/month after cauterization (p < 0.0001, paired t test).


CONCLUSIONS
Cauterization of endoscopically accessible small intestinal angiodysplasias may decrease rebleeding.
Askin
M P
MP
Division of Gastroenterology, Mount Sinai Medical Center, New York, USA.
Lewis
B S
BS
D000368:Aged; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000150:complications / Q000628:therapy*; D002425:Cautery / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome