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Br J Surg. 1997 Dec;84(12):1725-8.

Synchronous upper and lower gastrointestinal endoscopy is an effective method of investigating iron-deficiency anaemia.

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1
Department of Surgery, Frenchay Hospital, Bristol, UK.

Abstract

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.

PMID:
9448626
[Indexed for MEDLINE]

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