NDLI: A prospective evaluation of iron deficiency anemia in the GI endoscopy setting: role of standard endoscopy, videocapsule endoscopy, and CT-enteroclysis.

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A prospective evaluation of iron deficiency anemia in the GI endoscopy setting: role of standard endoscopy, videocapsule endoscopy, and CT-enteroclysis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Milano, Angelo Balatsinou, Chrysanthi Filippone, Antonella Caldarella, Maria Pia Laterza, Francesco Lapenna, Domenico Pierdomenico, Sante Donato Pace, Fabio Cuccurullo, Franco Neri, Matteo
Description	Country affiliation: Italy Author Affiliation: Milano A ( Department of Medicine and Aging Sciences, Section of Internal Medicine and Gastroenterology and Center for Excellence on Ageing (Ce.S.I.), G.D'Annunzio University and Foundation, Chieti, Italy.)
Abstract	BACKGROUND: Iron deficiency anemia (IDA) is a frequently encountered condition in clinical practice. After conventional endoscopy, the cause of anemia remains unknown in up to 40% of patients. OBJECTIVE: To evaluate prospectively the diagnostic efficacy of a systematic endoscopic approach to IDA and to compare the diagnostic yield of videocapsule endoscopy (VCE) and CT-enteroclysis in endoscopy-negative patients. DESIGN: Consecutive patients with IDA were enrolled prospectively. SETTING: Open-access endoscopy within an academic hospital. PATIENTS: This study involved 189 patients with IDA, including 98 women and 91 men; mean (±standard deviation) age 68 years±16.6 years. INTERVENTION: Patients with IDA underwent gastroscopy and colonoscopy plus ileoscopy. Endoscopy-negative patients were further blindly evaluated by both CT-enteroclysis and VCE. MAIN OUTCOME MEASUREMENTS: Diagnostic yield of conventional endoscopy; diagnostic yield of VCE versus CT-enteroclysis. RESULTS: Endoscopy results were positive in 144 of 189 patients (76.2%). CT-enteroclysis and VCE allowed a diagnosis in 37 of 45 endoscopy-negative patients (82.2%). Overall, VCE was superior to CT-enteroclysis (77.8% vs 22.2%; P<.001), in particular when flat lesions were found. LIMITATIONS: Single-center study. CONCLUSION: A systematic approach to IDA, which includes standard endoscopy, VCE, and CT-enteroclysis allows an overall diagnostic rate of 95.7%; however, CT-enteroclysis should be limited to cases of nondiagnostic VCE.
File Format	HTM / HTML
ISSN	00165107
Issue Number	5
Volume Number	73
e-ISSN	10976779
Journal	Gastrointestinal Endoscopy
Language	English
Publisher	Elsevier
Publisher Date	2011-05-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Gastroenterology Anemia, Iron-deficiency Diagnosis Capsule Endoscopy Methods Colonoscopy Gastrointestinal Hemorrhage Complications Gastroscopy Tomography, X-ray Computed Aged Etiology Celiac Disease Female Hemorrhoids Humans Inflammatory Bowel Diseases Male Middle Aged Prospective Studies Reproducibility Of Results Comparative Study Journal Article Randomized Controlled Trial
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Gastroenterology

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