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Master Thesis

Examen du grêle par vidéocapsule endoscopique : impact thérapeutique et recherche de facteurs prédictifs de rendement thérapeutique en cas d’anémie ferriprive avec ou sans saignement digestif extériorisé

Abstract : Introduction: Iron deficiency anemia is the main cause of anemia. The recommendations provide for a small bowel capsule endoscopy (SBCE) in case of obscure gastro-intestinal bleeding (OGIB) with or without exteriorization after complete endoscopic assessment. The diagnostic yield is currently well defined in contrast to the therapeutic impact. Aim: To determine the therapeutic impact of SBCE in context of OGIB and research for factors leading to a therapeutic act. Materials and methods: Monocentric retrospective study conducted from September 2017 to May 2019. 337 patients were included. Demographic characteristics, previous endoscopic and SBCE results; therapeutic acts, recurrence after SBCE were evaluated. Results: Three hundred and thirty seven patients of mean age 64.7 years old were studied, 203 occult digestive bleeding and 134 with digestive exteriorization. Lesions were objectified to 169 patients whether 50,1% (IC95%:44,8%;55,5%). An aimed at therapeutic treatment is performed in the case of positive SBCE for 119/169 patients, either an impact of 70,4% (IC95% 63,1–76,8%). Medical management for 21 patients (12.4%), an endoscopic procedure for 90 patients either 53.3% of which 55 with haemostasis procedure, or 8 surgical managements (4.7%). The factors motivating an aimed at therapeutic treatment are the type of lesion, mostly angiodysplasia P2 (p0.001) and exteriorization (p=0.012). These angiodysplasia P2 are lesions at risk of recurrence in the medium term (p<0.001). Conclusion: The SBCE has a significant therapeutic impact in case of a positive diagnosis in the context of OGIB to target management based on the detected lesion.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02490887
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Submitted on : Tuesday, February 25, 2020 - 3:48:58 PM
Last modification on : Friday, October 23, 2020 - 4:57:52 PM
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  • HAL Id : dumas-02490887, version 1

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Yoann Chapelain. Examen du grêle par vidéocapsule endoscopique : impact thérapeutique et recherche de facteurs prédictifs de rendement thérapeutique en cas d’anémie ferriprive avec ou sans saignement digestif extériorisé. Médecine humaine et pathologie. 2019. ⟨dumas-02490887⟩

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