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Gastrointestinal endoscopy · 2026

Location of gastrointestinal lesions with bleeding potential in patients with iron deficiency anemia: a multicenter prospective study.

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Oka Priya, Tai Foong W D, Shiha Mohamed G, Nowak Tanja, Finta Ádám, Madácsy László, Wong Marc T L, Yu Yuanyuan K, Lau James Y W, McAlindon Mark E

Аннотация

BACKGROUND AND AIMS: Guidelines recommend EGD and colonoscopy to investigate iron deficiency anemia (IDA), but not small-bowel examination. The aim of the study was to determine the diagnostic yield and location of lesions causing IDA by performing a pan-enteric examination.

METHODS: In a prospective, multicenter clinical trial involving 2 public hospitals (United Kingdom and Hong Kong) and a private health center (Hungary), patients underwent small-bowel capsule endoscopy, EGD, and colonoscopy. All lesions identified were described by a blinded consensus panel using a diagnostic register and the Saurin classification (P1 and P2: possible and likely causes of bleeding, respectively).

RESULTS: In 170 patients (median, 60.0 years; 47.6% female), small-bowel capsule endoscopy identified P1 or P2 lesions in 85 patients (50.0%; 95% CI, 42.2-57.7), EGD identified in 48 patients (28.2%; 95% CI, 21.6-35.6), and colonoscopy identified in 34 patients (20.0%; 95% CI, 14.2-26.8). The yield of capsule endoscopy for P1 or P2 lesions was higher than EGD (P < .001) and colonoscopy (P < .0001). P2 lesions alone were identified in 17 (10.0%; 95% CI, 6.0-15.5), 11 (6.5%; 95% CI, 3.3-11.3), and 16 (9.4%; 95% CI, 5.4-14.8) patients, respectively. Pan-GI endoscopy identified potential bleeding lesions in 121 patients (71.1%; 95% CI, 64.4-77.9), which changed management in 89 patients (52.3%; 95% CI, 44.5-60.0).

CONCLUSIONS: Over two-thirds of patients with IDA had lesions with bleeding potential and they were more common in the small bowel than the upper GI tract and colon.

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

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