Do All Patients with Iron Deficiency Anaemia Need D2 Biopsies?

Category: Upper Gastrointestinal

Aims: Biopsies of the second part of the duodenum (D2) are routinely taken in patients undergoing oesophagogastrodoudenoscopy (OGD) as investigation for iron deficiency anaemia (IDA) and cost approximately (pound))280 per patient. The aim of this study was to identify the need for routine D2 biopsies in patients with IDA.

Methods: All patients undergoing OGD for IDA over a 2 year period in a single unit were included. Patient data and histology were obtained from a prospectively maintained database and histopathology records.

Results: One hundred and twelve patients underwent OGD as investigation for iron deficiency anaemia between January 2004 and December 2005. D2 biopsies were not taken in 8. One hundred and four patients were included. Five had endoscopic features consistent with coeliac disease (CD). Three of these had D2 histology diagnostic of CD. No patients with normal endoscopic appearances of the small bowel had positive D2 biopsises. Avoiding D2 biopsy in these patients would have saved €27,720.

Conclusions: Patients with IDA and macroscopically normal small bowel may not require routine D2 biopsy.