[Algorithm for diagnosis of small intestinal diseases].

Area of Science:

• Gastroenterology
• Internal Medicine
• Diagnostic Medicine

Background:

• Chronic small intestine diseases encompass a wide spectrum of conditions affecting nutrient absorption and gut function.
• Accurate diagnosis is crucial for effective management and improving patient outcomes.

Purpose of the Study:

• To review and outline the diagnostic approaches for various chronic diseases affecting the small intestine.
• To highlight the spectrum of conditions encountered, from common to rare.

Main Methods:

• Analysis of 1096 patient cases admitted to the Central Research Institute of Gastroenterological Diseases between 1987 and 2006.
• Review of diagnostic methods including radiological, endoscopic, histological, and immunological techniques.

Main Results:

• Celiac disease, disaccharidase deficiency, ileitis, Crohn's disease, short bowel syndrome, and mesenteric ischemia were most prevalent (90.5%).
• Rare conditions like hypogammaglobulinemia, lymphoma, Whipple's disease, and diverticulosis accounted for 5.8% of cases.
• Very rare diseases (3.7%) included amyloidosis, eosinophilic gastroenteritis, pseudoobstruction, lymphangiectasia, and various syndromes.

Conclusions:

• Clinical diagnosis is guided by syndromes such as chronic diarrhea, malabsorption, protein loss, obstruction, and hemorrhage.
• Differential diagnosis utilizes a combination of imaging, endoscopic, histological, and immunological investigations.
• Most small intestinal diseases, including rare ones, are diagnosable within standard gastroenterology departments.