Demir eksikliği anemisi ile başvuran erkek ve kadın hastaların endoskopik verilerinin retrospektif değerlendirilmesi
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Date
2018
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Bolu Abant İzzet Baysal Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Demir eksikliği anemisi en sık görülen anemi çeşidi olup, sıklığı ve nedeni hasta populasyonlarına göre değişiklik göstermektedir. Erkek ve postmenopozal kadın hastalarda, demir eksikliği anemisinin en sık sebebi gastrointestinal sistem kaynaklı kronik kan kaybı ya da emilim bozukluğunun olmasıdır.Çalışmamızda erkek ve postmenopozal kadın hastalarda demir eksikliği anemisine yol açabilecek gastrointestinal patolojileri belirlemek amaçlandı. Bu amaçla Ocak 2016 -Aralık 2017 tarihleri arasında Abant İzzet Baysal Eğitim ve Araştırma Hastanesi Endoskopi Ünitesi'ne başvuran toplam 234 hasta retrospektif olarak değerlendirildi. Çalışmaya katılan hastaların 126'sı erkek 108'i kadın idi. Hastaların yaş ortalamasının 64,17 olduğu, erkek ve kadın hastalarda benzer olduğu görüldü. Hastaların %86,7 sine ÖGD, %44,4 üne kolonoskopi, %31,2 sine hem ögd hem kolonoskopi yapıldığı görüldü. ÖGD'de lezyon tespiti %96, kolonoskopide lezyon tespiti %56, ÖGD ve kolonoskopinin birlikte yapıldığı hastalarda lezyon tespit oranı %97,3 olduğu görüldü. ÖGD yapılan hastalarda en sık görülen lezyonlar sırasıyla noneroziv gastrit, eroziv gastrit ve bulboduodenitler olarak saptandı. Gastrik ülser %11,3 bulboduodenal ülser %5,9 oranında görüldü. %6,9 hastada gastrektomitespit edildi. Endoskopik biopsi sonrası Helikobakter pozitifliği %35,4 gastrik atrofi %13,3 çölyak hastalığı ise %1,4 oranında bulundu. 1 hastada özefagusda malign görünümlü kitle görüldü. Kolonoskopi verilerine bakıldığında en sık görülen lezyonlar sırasıyla polip, hemoroid ve divertikül olarak saptandı. Poliplerin genelde sayıca <3 ve büyüklük olarak <1cm olduğu görüldü. Divertiküller %81,8 oranında sol kolonda bulundu. İnflamatuar barsak hastalığı sıklığı %5,8 tespit edildi, sayıca ülseratif kolitin crohn'dan daha fazla olduğu görüldü. Sadece sol kolonda olmak üzere 1 hastada anjiodisplazi görüldü. Üst gis taramasında malignite %5,1 gastrik adenoca oranı %3,6 oranında görüldü. Kolorektal malignite oranı %2,9 olarak tespit edildi, sol kolon/sağ kolon oranı 2:1olduğu görüldü. Sonuç olarak yapmış olduğumuz bu çalışmada erkek ve postmenopozal kadın hastalarda, demir eksikliği anemisinde gastrointestinal sistem kaynaklı lezyonların büyük oranda eşlik ettiğini gördük. Lezyonların çeşitliliği ve tedavileri yapılmadığında oluşabilecek komplikasyonlar göz önünde bulundurulduğunda hem üst hem alt gis endoskopiler birlikte ve demir eksikliği anemisi tanısı konulur konulmaz vakit kaybedilmeden yapılmalıdır. Anahtar kelimeler:Demir eksikliği anemisi, Kolonoskopi, Özefagogastroduodenoskopi
Iron deficiency anemia is the most common type of anemia, and its frequency and cause varies according to patient populations. The most common cause of iron deficiency anemia in male and postmenopausal female patients is chronic blood loss or impaired gastricum due to gastrointestinal system. In our study, we aimed to determine the gastrointestinal pathologies which may lead to anemia of iron deficiency in male and postmenopausal female patients. A total of 234 patients who applied to the Abant Izzet Baysal Training and Research Hospital Endoscopy Unit between January 2016 and December 2017 were retrospectively evaluated for this purpose. Of the patients participating in the study, 126 were male and 108 were female. It was seen that the mean age of the patients was 64,17, similar to that of male and female patients. Of the patients, 86.7% were diagnosed with EGD, 44.4% with colonoscopy, 31.2% with both eugenics and colonoscopy. Lesion detection was found to be 96% in EGD, lesion detection was 56% in colonoscopy and 97.3% in patients with combined EGD and colonoscopy. The most common lesions in patients with OGD were nonerosive gastritis, erosive gastritis and bulboduodenitis, respectively. Gastric ulcer 11.3% and bulboduodenal ulcer 5.9% were seen. 6.9% patient gastrectomy was detected. After endoscopic biopsy, H. pylori positivity was 35.4%, gastric atrophy was 13.3% and celiac disease was 1.4%. A malignant mass was seen in the esophagus in one patient. When colonoscopy data were analyzed, the most common lesions were polyps, hemorrhoids, and diverticula, respectively. Polies were generally found to be <3 in number and <1 cm in size. Diverticulitis was found in the left arm by 81.8%. Inflammatory bowel disease frequency was found to be 5.8%, with ulcerative colitis appearing to be greater than Crohn's. Angiodisplasia was seen in 1 patient, only in the left fistula. Malignancy rate of 5.1% and gastric adenocarcinoma rate of 3.6% were seen in upper gastrointestinal tract screening. The colorectal malignancy rate was found to be 2.9%, with a left to right colon ratio of 2:1.In conclusion, we have seen that in male and postmenopausal female patients, lesions originating from the gastrointestinal tract are accompanied by a large proportion of iron deficiency anemia. Considering the complications that may arise when the lesions are not treated and the variety of the lesions, both upper and lower endoscopes should be done together and the diagnosis of iron deficiency anemia must be made without losing time. Key words: Iron deficiency anemia, Colonoscopy, Esophagogastroduodenoscopy
Iron deficiency anemia is the most common type of anemia, and its frequency and cause varies according to patient populations. The most common cause of iron deficiency anemia in male and postmenopausal female patients is chronic blood loss or impaired gastricum due to gastrointestinal system. In our study, we aimed to determine the gastrointestinal pathologies which may lead to anemia of iron deficiency in male and postmenopausal female patients. A total of 234 patients who applied to the Abant Izzet Baysal Training and Research Hospital Endoscopy Unit between January 2016 and December 2017 were retrospectively evaluated for this purpose. Of the patients participating in the study, 126 were male and 108 were female. It was seen that the mean age of the patients was 64,17, similar to that of male and female patients. Of the patients, 86.7% were diagnosed with EGD, 44.4% with colonoscopy, 31.2% with both eugenics and colonoscopy. Lesion detection was found to be 96% in EGD, lesion detection was 56% in colonoscopy and 97.3% in patients with combined EGD and colonoscopy. The most common lesions in patients with OGD were nonerosive gastritis, erosive gastritis and bulboduodenitis, respectively. Gastric ulcer 11.3% and bulboduodenal ulcer 5.9% were seen. 6.9% patient gastrectomy was detected. After endoscopic biopsy, H. pylori positivity was 35.4%, gastric atrophy was 13.3% and celiac disease was 1.4%. A malignant mass was seen in the esophagus in one patient. When colonoscopy data were analyzed, the most common lesions were polyps, hemorrhoids, and diverticula, respectively. Polies were generally found to be <3 in number and <1 cm in size. Diverticulitis was found in the left arm by 81.8%. Inflammatory bowel disease frequency was found to be 5.8%, with ulcerative colitis appearing to be greater than Crohn's. Angiodisplasia was seen in 1 patient, only in the left fistula. Malignancy rate of 5.1% and gastric adenocarcinoma rate of 3.6% were seen in upper gastrointestinal tract screening. The colorectal malignancy rate was found to be 2.9%, with a left to right colon ratio of 2:1.In conclusion, we have seen that in male and postmenopausal female patients, lesions originating from the gastrointestinal tract are accompanied by a large proportion of iron deficiency anemia. Considering the complications that may arise when the lesions are not treated and the variety of the lesions, both upper and lower endoscopes should be done together and the diagnosis of iron deficiency anemia must be made without losing time. Key words: Iron deficiency anemia, Colonoscopy, Esophagogastroduodenoscopy
Description
Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı
Keywords
Gastroenteroloji, Gastroenterology
