Demir eksikliği anemisi olan yaşlı hastalarda endoskopik bulguların değerlendirilmesi

Amaç: Endoskopik işlemler için önemli bir endikasyon olan demir eksikliği anemisinin geriatrik popülasyonda varlığı, gastrointestinal sistemde olası bir maligniteyi dışlamayı gerektirmektedir. Bu çalışmada amaç demir eksikliği anemisi nedeni ile özofagogastroduodenoskopi ve kolonoskopi yapılan geriatrik popülasyonda endoskopik bulguların incelenmesidir. Gereç ve Yöntem: Ağustos 2019-Ağustos 2020 tarihleri arasında demir eksikliği anemisi nedeni ile özofagogastroduodenoskopi ve kolonoskopi yapılan 65 yaş ve üzeri 60 olgu retrospektif olarak değerlendirilmiştir. Hastaların yaş, cinsiyet, geriatrik yaş grupları, alınan mide biyopsisinde Helicobacter pylori varlığı, özofagoduodenoskopi bulguları, kolonoskopi bulguları, internal ve/veya eksternal hemoroid varlığı, duodenum biyopsisi sonuçları incelenmiştir.Bulgular: Çalışmaya dahil edilen 60 hastanın 30’u (%50) erkekti ve yaş ortalaması 72,47 ± 6,07 yıldı. Hastaların 41’i (%68,4) genç yaşlı, 17’si (%28,3) orta yaşlı ve 2’si (%3,3) ileri yaşlıydı. Özofagogastroduodenoskopide demir eksikliği anemisini açıklayabilecek en sık bulgular sırasıyla; atrofik gastrit %21,2, Helicobacter pylori pozitif gastrit %20, mide polipi %11,7, mide kanseri %3,3 iken, kolonoskopik bulgular ise sırasıyla kolon polibi %23,3 hastada, divertikül %15, anjiodisplazi %15, kolon kanseri %8,3 saptandı. Hastaların 44 (%73,3)’ünde internal hemoroid izlendi. Sonuç: Yaşlı popülasyonda gastrointestinal sistemden kan kaybı demir eksikliği anemisinin en önemli nedeni olup, anal bakıda hemoroidlerin görülmesi tek başına demir eksikliği anemisini açıklayamamaktadır. Demir eksikliği anemisi tanısı alan hastaların etiyolojisi araştırılırken hem özofagogastroduodenoskopi hem de kolonoskopi yapılması altta yatan nedene ulaşmak ve olası bir malignitenin atlanmaması açısından doğru bir yaklaşımdır.

Endoscopic findings in the older patients with iron-deficiency anemia

Aim: The presence of iron-deficiency anemia, which is an important indication for endoscopic procedures, in the geriatric population necessitates the exclusion of a possible malignancy in the gastrointestinal system. This study aims to examine endoscopic findings in geriatric patients that underwent esophagogastroduodenoscopy and colonoscopy because of iron-deficiency anemia. Materials and Methods: Sixty patients aged 65 and over who underwent esophagogastroduodenoscopy and colonoscopy because of iron-deficiency anemia between August 2019 and August 2020 were retrospectively evaluated. Age, sex, geriatric age groups of patients, presence of Helicobacter pylori in gastric biopsy, esophagogastroduodenoscopy findings, colonoscopy findings, presence of internal and / or external hemorrhoids, and duodenal biopsy results were examined. Results: Thirty (50%) of 60 patients included in the study were male and the mean age was 72.47 ± 6.07 years. Of these patients, 41 (68.4%) were young-old, 17 (28.3%) were middle-old and 2 (3.3%) were old-old. The most common causes that might explain iron-deficiency anemia in esophagogastroduodenoscopy were atrophic gastritis (21.2%), Helicobacter pylori-positive gastritis (20%), gastric polyp (11.7%), and gastric cancer (3.3%), whereas colonoscopy results were found colon polyps in 23.3% of patients, diverticulum in 15% and angiodysplasia in 15%, and colon cancer in 8.3%. Internal hemorrhoids were also observed in 44 (73.3%) patients. Conclusion: In the older population, blood loss from the gastrointestinal system is the most important cause of iron-deficiency anemia and just hemorrhoids cannot explain IDA. While examining the etiology of patients diagnosed with iron-deficiency anemia, performing both esophagogastroduodenoscopy and colonoscopy is an accurate approach to reach the underlying cause and not to miss a possible malignancy.

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