Iron-deficiency anemia
ICD-10 D50 · ICD-11 3A00

Treatment of Iron-Deficiency Anemia with Suspected Small-Bowel Bleeding Angioectasias

This protocol covers iron-deficiency anemia in patients where small-bowel angioectasias are the suspected source of gastrointestinal blood loss — a clinical scenario that calls for a specific diagnostic and therapeutic endoscopic strategy beyond conventional upper and lower endoscopy.

Clinical Scenario
In patients with iron-deficiency anemia in whom small-bowel bleeding from angioectasias is suspected, the evaluation requires a dedicated deep enteroscopic approach. Technique optimisation during the procedure is essential for both detection of lesions and the ability to intervene.
Approach Overview
Management involves deep enteroscopy performed with a distal attachment to improve detection of angioectasias, combined with endoscopic treatment of identified lesions and concurrent iron replacement.
The full protocol details the complete treatment algorithm, the available endoscopic modalities, and the accompanying interventions — access it below.
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References

Deep enteroscopy performed in patients with iron-deficiency anemia suspected to have small-bowel bleeding angioectasias should be performed with a distal attachment to improve detection and facilitate treatment.

Small-bowel angioectasias may be treated with ablative thermal therapies such as argon plasma coagulation or with mechanical methods such as hemostatic clips.

Endoscopic treatment of angioectasias should be accompanied with iron replacement.

DOI: 10.1016/j.cgh.2024.03.046

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