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. 1985 Sep 21;291(6498):769–772. doi: 10.1136/bmj.291.6498.769

Small bowel biopsy for malabsorption: comparison of the diagnostic adequacy of endoscopic forceps and capsule biopsy specimens.

A S Mee, M Burke, A G Vallon, J Newman, P B Cotton
PMCID: PMC1417146  PMID: 3929934

Abstract

Biopsy specimens of the small bowel were obtained from 40 patients suspected of having malabsorption. Four different techniques were used at a single session--namely, endoscopic biopsy of the descending duodenum using paediatric and standard size forceps and suction capsule biopsy of the descending duodenum and the proximal jejunum. Specimens were compared for size, adequacy, and ability to confirm or exclude mucosal abnormality. Fourteen patients had villous atrophy. In all patients four biopsy specimens were obtained with paediatric endoscopic forceps and four with standard endoscopic forceps. No capsule biopsy specimen was retrieved from the duodenum in three patients and from the jejunum in five patients. Specimens were considered to be adequate in 36 patients when paediatric forceps were used, in 39 when standard forceps were used, in 28 on duodenal capsule biopsy, and in 32 on jejunal capsule biopsy. This study indicates that the most reliable method for diagnosing or excluding villous atrophy is endoscopic forceps biopsy of the descending duodenum, provided that at least four specimens are obtained with standard size forceps.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cotton P. B. Overtubes (sleeves) for upper gastrointestinal endoscopy. Gut. 1983 Sep;24(9):863–866. doi: 10.1136/gut.24.9.863. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Gillberg R., Ahrén C. Coeliac disease diagnosed by means of duodenoscopy and endoscopic duodenal biopsy. Scand J Gastroenterol. 1977;12(8):911–916. doi: 10.3109/00365527709181349. [DOI] [PubMed] [Google Scholar]
  3. Gillberg R., Kastrup W., Mobacken H., Stockbrügger R., Ahrén C. Endoscopic duodenal biopsy compared with biopsy with the Watson capsule from the upper jejunum in patients with dermatitis herpetiformis. Scand J Gastroenterol. 1982 Mar;17(2):305–308. doi: 10.3109/00365528209182058. [DOI] [PubMed] [Google Scholar]
  4. Holdstock G., Eade O. E., Isaacson P., Smith C. L. Endoscopic duodenal biopsies in coeliac disease and duodenitis. Scand J Gastroenterol. 1979;14(6):717–720. doi: 10.3109/00365527909181943. [DOI] [PubMed] [Google Scholar]
  5. Holdstock G. Jejunal biopsy without the need for screening. Lancet. 1978 Jun 10;1(8076):1236–1237. doi: 10.1016/s0140-6736(78)92469-8. [DOI] [PubMed] [Google Scholar]
  6. Korn E. R., Foroozan P. Endoscopic biopsies of normal duodenal mucosa. Gastrointest Endosc. 1974 Nov;21(2):51–54. doi: 10.1016/s0016-5107(74)73790-7. [DOI] [PubMed] [Google Scholar]
  7. Lee J. H., Griffiths W. J., Zantout I., Welsh J. D. Adequacy of endoscopic biopsy specimens for disaccharidase assays. Am J Dig Dis. 1978 Dec;23(12):1129–1131. doi: 10.1007/BF01072890. [DOI] [PubMed] [Google Scholar]
  8. MACDONALD W. C., BRANDBORG L. L., FLICK A. L., TRIER J. S., RUBIN C. E. STUDIES OF CELIAC SPRUE. IV. THE RESPONSE OF THE WHOLE LENGTH OF THE SMALL BOWEL TO A GLUTEN-FREE DIET. Gastroenterology. 1964 Dec;47:573–589. [PubMed] [Google Scholar]
  9. Prout B. J. A rapid method of obtaining a jejunal biopsy using a Crosby capsule and a gastrointestinal fiberscope. Gut. 1974 Jul;15(7):571–572. doi: 10.1136/gut.15.7.571. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. 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]
  11. SHEEHY T. W. INTESTINAL BIOPSY. Lancet. 1964 May 2;1(7340):959–962. doi: 10.1016/s0140-6736(64)91747-7. [DOI] [PubMed] [Google Scholar]
  12. SMITH R. B., SPRINZ H., CROSBY W. H., SULLIVAN B. H., Jr Peroral small bowel mucosal biopsy. Am J Med. 1958 Sep;25(3):391–394. doi: 10.1016/0002-9343(58)90077-9. [DOI] [PubMed] [Google Scholar]
  13. Scott B. B., Jenkins D. Endoscopic small intestinal biopsy. Gastrointest Endosc. 1981 Aug;27(3):162–167. doi: 10.1016/s0016-5107(81)73183-3. [DOI] [PubMed] [Google Scholar]
  14. Stevens F. M., McCarthy C. F. The endoscopic demonstration of coeliac disease. Endoscopy. 1976 Nov;8(4):177–180. doi: 10.1055/s-0028-1098406. [DOI] [PubMed] [Google Scholar]
  15. Whitehead R., Roca M., Meikle D. D., Skinner J., Truelove S. C. The histological classification of duodenitis in fibreoptic biopsy specimens. Digestion. 1975;13(3):129–136. doi: 10.1159/000197701. [DOI] [PubMed] [Google Scholar]

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