Routine jejunal endoscopic biopsy in children

The aim of the study was to evaluate and compare two methods of jejunal biopsy-endoscopic (EB) and suction (SB). Jejunal EB was performed using an Olympus GIF P20 endoscope in 119, and SB with a modified Crosby capsule in 254 patients. A light microscope with micrometer was used for the analysis and measurement of biopsy specimens. Calculated per patient, the total average number of all adequate specimens was: jejunal or duodenal mucosa -2.97 in EB and 0.93 in SB; jejunal mucosa only -2.82 in EB and 0.89 in SB group. Duodenal mucosa was unintentionally biopsied in 17.1% of EB and in 3.7% of SB. Jejunal mucosal specimens were selected for measurement at random -82 from the EB and 24 from the SB group. The difference in height between EB and SB specimens was not significant (EB: 0.72 +/- 0.13 mm; vs SB: 0.77 +/- 0.14 mm). The difference in length was significant (EB: 2.57 +/- 1.24 mm; vs SB: 3.22 +/- 1.38 mm; P = 0.03). The advantages of the EB over the SB technique included elimination of fluoroscopy, no failures in obtaining biopsies and a 97% success rate in obtaining specimens adequate for histological analysis. It also enabled the biopsy site to be chosen and several specimens to be taken, providing additional tissue for various analyses.

Jejunal endoscopic biopsy is suggested as a good alternative to the suction biopsy, wherever paediatric upper gastrointestinal endoscopy is available.