Abstract
Two hundred and seventy-eight duodenal biopsy specimens taken consecutively from children using either a single port paediatric Crosby capsule or a double port modification were examined both histologically and by dissecting microscopy, in order to determine the incidence of patchy mucosal lesions. One hundred and six specimens were abnormal and 49 of these were patchy. Patchy lesions occurred most commonly in cow's milk sensitive enteropathy where 66% of 33 specimens were patchy; in comparison all children with undiagnosed coeliac disease taking a normal diet showed a uniformly flat mucosa. Twenty-two per cent of specimens taken using the double port and 10% using the single port capsule were patchy, a statistically significant difference (P = 0.01) using standard errors. Where lesions were uniform, grading by dissecting microscopy correlated well with histological grading; 18 (37%) of specimens were, however, recognised as patchy only on gross appearance. The high incidence of patchy lesions of the proximal small intestine reflected the prevalence of cow's milk protein intolerance and the postenteritis syndrome in these children. The use of the double port capsule and of dissecting microscopy also contributed to the high incidence found.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ament M. E., Rubin C. E. An infant multipurpose biopsy tube. Gastroenterology. 1973 Aug;65(2):205–209. [PubMed] [Google Scholar]
- CROSBY W. H., KUGLER H. W. Intraluminal biopsy of the small intestine; the intestinal biopsy capsule. Am J Dig Dis. 1957 May;2(5):236–241. doi: 10.1007/BF02231100. [DOI] [PubMed] [Google Scholar]
- Gribbin M., Walker-Smith J., Wood C. Delayed recovery following acute gastroenteritis. Acta Paediatr Belg. 1976 Jul-Sep;29(3):167–176. [PubMed] [Google Scholar]
- Harrison M., Kilby A., Walker-Smith J. A., France N. E., Wood C. B. Cows' milk protein intolerance: a possible association with gastroenteritis, lactose intolerance, and IgA deficiency. Br Med J. 1976 Jun 19;1(6024):1501–1504. doi: 10.1136/bmj.1.6024.1501. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kilby A. Paediatric small intestinal biopsy capsule with two ports. Gut. 1976 Feb;17(2):158–159. doi: 10.1136/gut.17.2.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Latham S., Becket A. J., Chapell D. A. Further modifications in the children's jejunal biopsy capsule. Br Med J. 1969 Apr 26;2(5651):243–243. doi: 10.1136/bmj.2.5651.243. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Perera D. R., Weinstein W. M., Rubin C. E. Symposium on pathology of the gastrointestinal tract-Part II. Small intestinal biopsy. Hum Pathol. 1975 Mar;6(2):157–217. doi: 10.1016/s0046-8177(75)80176-6. [DOI] [PubMed] [Google Scholar]
- Rubin C. E., Dobbins W. O., 3rd Peroral biopsy of the small intestine. A review of its diagnostic usefulness. Gastroenterology. 1965 Dec;49(6):676–697. [PubMed] [Google Scholar]
- Scott B. B., Losowsky M. S. Patchiness and duodenal-jejunal variation of the mucosal abnormality in coeliac disease and dermatitis herpetiformis. Gut. 1976 Dec;17(12):984–992. doi: 10.1136/gut.17.12.984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thompson H. Coeliac disease. The small intestine at autopsy. Clin Gastroenterol. 1974 Jan;3(1):171–181. [PubMed] [Google Scholar]
- Walker-Smith J. A., Reye R. D. Small intestinal morphology in aboriginal children. Aust N Z J Med. 1971 Nov;1(4):377–384. doi: 10.1111/j.1445-5994.1971.tb02548.x. [DOI] [PubMed] [Google Scholar]
- Walker-Smith J. A. Uniformity of dissecting microscope appearances in proximal small intestine. Gut. 1972 Jan;13(1):17–20. doi: 10.1136/gut.13.1.17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Walker-Smith J., Harrison M., Kilby A., Phillips A., France N. Cows' milk-sensitive enteropathy. Arch Dis Child. 1978 May;53(5):375–380. doi: 10.1136/adc.53.5.375. [DOI] [PMC free article] [PubMed] [Google Scholar]