Clinical Utility Of Duodenal Biopsies In The Diagnosis Of Chronic Diarrhea. A Retrospective Study

Aims According to published guidelines, in patients with chronic diarrhea, when no diagnosis can be made by laboratory studies and/or ileocolonoscopy an upper GI endoscopy with duodenal biopsy sampling should be executed. Aim of our study was to access the clinical benefit of such a strategy.

Methods All patients who underwent an upper GI endoscopy in our department due to chronic diarrhea during a five year period (1/2015-12/2019) were included in our study. Epidemiological, endoscopic and histologic data were analyzed.

Results Totally 169 patients with chronic diarrhea were included. Biopsy samples were taken by 108 patients (M/F: 48/63, median age 55 years [16-86]) and the histology report was available in 100 of them. Endoscopic abnormalities of the duodenal mucosa were reported in 42 (38,9 %) pts. Bulb atrophy with visible submucosal vessels, combined with flattening or scalloping of Kerckring folds was reported among 15/42, mucosal edema and/or hyperemia in 9/42 and other/non-specific findings in 18 pts. Histology was indicative of a specific diagnosis in 25 pts: Celiac disease in 10/25, crohn’s disease in 3/25 and other specific pathology in 12/25 pts. In pts without pathological endoscopic findings, histology added diagnostically in 7/60 (11,7 %) pts, while among pts with visible duodenal abnormalities in 18/42 (45 %) pts(p<0,001). Among pts with loss, and flattening or scalloping of Kerckring folds, the histologic report added diagnostically in 9/15 without though being correlated to celiac disease diagnosis (4/9(p=0,500).

Conclusions Duodenal biopsy sampling is helpful in the diagnosis of approximately 1/10 patients with chronic diarrhea and abscence of specific endoscopic findings. This effect increases significantly to 45 % among patients with endoscopically visible duodenal abnormalities.

Citation Voulgaris T, Tampaki M, Laoudi E et al. eP111 CLINICAL UTILITY OF DUODENAL BIOPSIES IN THE DIAGNOSIS OF CHRONIC DIARRHEA. A RETROSPECTIVE STUDY. Endoscopy 2021; 53: S132.

Publication History

Article published online:
19 March 2021