Orhan COŞKUN, Mustafa ÇAPRAZ, Zeynep ÇETİN

Güncel klavuzlar eşliğinde demir eksikliği olan hastalarda gastrointestinal endoskopik inceleme sonuçlarının değerlendirilmesi

Giriş: Erişkin hastalarda kronik kan kaybı ve demirin intestinal emilim bozukluğu demir eksikliğinin (DE) iki önemli nedenidir. Bu çalışmamızda demir eksikliği nedeniyle endoskopik inceleme yaptığımız hastaların demografik verilerini ve endoskopi bulgularımızı değerlendirdik. Gereç ve Yöntem:Çalışma retrospektif olarak dizayn edildi. Haziran 2017-Nisan 2020 tarihleri arasında hastanemiz endoskopi ünitesinde DE ve/veya DEA nedeniyle endoskopik inceleme yapılan hastalar veri tabanı taranarak bulundu. Aktif kanama bulgusu olan hastalar dışlandıktan sonra kalan 326 hasta değerlendirildi. Bulgular:Hastaların median yaşı 58’di. 182’si erkek (%55.8), 144’ü kadındı (%44.2). Hastaların %28,5’i (n=93) 50 yaş ve altında iken, %71,5’i (n=133) 50 yaşın üzerindeydi. %13,2’sine endoskopi (ÖGD), %2,5’ine kolonoskopi, %84,4’üne endoskopi+kolonoskopi (çift yönlü işlem) birlikte yapılmıştı. Yapılan endoskopik incelemeler sonrasında hastaların %69,3’ünde DE/DEA’ya neden olabilecek patolojik bulgular saptanırken %30,7’sinde DE/DEA’ya neden olabilecek sindirim kanalı patolojisi izlenmedi. Hastaların 12’sinde (%3,8) malignite saptandı. Endoskopik incelemeler esnasında DE/DEA’ya neden olabilecek herhangi bir patoloji saptanması; sadece ÖGD veya kolonoskopi yapılan hastalarla (%43,1) karşılaştırıldığında; çift yönlü inceleme yapılan hasta grubunda (%74,2) istatistiksel olarak daha fazlaydı (p<0,001). Ayrıca çift yönlü inceleme yapılan hastaların %17,5’inde hem alt hem de üst GİS’te DE/DEA’ya neden olabilecek eş zamanlı patoloji saptandı. Sonuç: Klavuzlarda önerildiği şekilde endoskopik incelemelerin çift yönlü yapılması, tek yönlü incelemelere göre tanısal etkinliği artırır.

Anahtar Kelimeler:

Demir eksikliği, anemi, kolonoskopi, endoskopi

An evaluation of gastrointestinal endoscopic examination outcomes in patients with iron deficiency through guidelines

Introduction:Chronic blood loss and intestinal malabsorption of iron are two important causes of iron deficiency in adult patients.We evaluated the demographic data and endoscopy findings of patients who underwent endoscopic examination due to iron deficiency. Materials and Method:The study was designed retrospectively.The database of patients who underwent endoscopic examination due to ID and/or IDA in the endoscopy unit of our hospital between June 2017-April 2020 were found through the database scan. After exclusion of patients with active bleeding finding, remaining 326 patients were evaluated. Findings:Median age of the patients was 58 years. The participants included 182 males and 144 females. Ninety three patients were below 50 years of age whereas 133 patients were above 50 years of age. Endoscopy was performed in 13.2% of the patients; colonoscopy was performed in 2.5% of the patients; and endoscopy + colonoscopy (dual procedure) was performed in 84.4% of the patients. Endoscopic examinations revealed pathological findings that may cause ID/IDA in 69.3% of the patients; however, no gastrointestinal pathology that may cause ID/IDA was detected in 30.7% of the patients.Twelve patients were diagnosed with malign diseases. Detection of any pathology that may cause ID/IDA during endoscopic examinations was significantly more in the dual examination group when compared to patients who had EGD or colonoscopy (p<0.001). Furthermore, concomitant pathologies that may cause ID/IDA in both lower and upper GIS were detected in 17.5% of the patients in the dual examination group. Conclusion:Dual endoscopic examinations according to guideline recommendations increase diagnostic efficiency compared to one-sided examinations.

Keywords:

İron deficiency, anemia, colonoscopy, endoscopy,

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