Push enteroscopy in celiac sprue and refractory sprue - 08/09/11

Doi : 10.1016/S0016-5107(99)80007-8

Christophe Cellier, MD, PhD ^a,^b,^c,^d,^⁎ , Emmanuel Cuillerier, MD ^a,^b,^c,^d, Natacha Patey-Mariaud de Serre, MD, PhD ^a,^b,^c,^d, Philippe Marteau, MD, PhD ^a,^b,^c,^d, Viriginie Verkarre, MD ^a,^b,^c,^d, Josette Brière, MD ^a,^b,^c,^d, Nicole Brousse, MD ^a,^b,^c,^d, Jean-Philippe Barbier, MD ^a,^b,^c,^d, Jacques Schmitz, MD ^a,^b,^c,^d, Bruno Landi, MD ^a,^b,^c,^d
^a Department of Hepato-Gastroenterology Laennec Hospital Assistance Publique-Hôpitaux de Paris France
^b Department of Pathology, Laennec Hospital Assistance Publique-Hôpitaux de Paris France
^c Department of Laennec Hospital Necker Hospital, Assistance Publique-Hôpitaux de Paris France
^d Department of Laennec Hospital Assistance Publique-Hôpitaux de Paris Université René Descartes, Paris, France.

^*Reprint requests: Christophe Cellier, MD, PhD, Hôpital Laennec and Hôpital Européen Georges Pompidou, Service de Gastroentérologie, 42, rue de Sèvres, 75007 Paris, France;

Abstract

Background: The aim of this study was to determine in patients with sprue whether jejunal endoscopy improves the diagnostic yield or provides information that may modify management, when compared with evaluation limited to the duodenum.

Methods: From January 1994 to June 1998, a total of 31 patients (6 men, 25 women, mean age 41 years) were prospectively evaluated by push enteroscopy. They were divided into two groups: (1) celiac disease at different stages of activity (n=23) and (2) refractory sprue (n=8). The endoscopic and histologic findings in the duodenum and in the jejunum were compared.

Results: Celiac disease: In 19 patients, endoscopic and histologic findings in the duodenum and jejunum were similar; in four patients villous atrophy was more severe in the duodenum than in the jejunum. Refractory sprue: In 5 of 8 patients, enteroscopy revealed ulcerative jejunitis, whereas ulcerations were found in the duodenum in only one case.

Conclusion: In refractory sprue, push enteroscopy with jejunal biopsies was of diagnostic value in 50% of cases demonstrating ulcerative jejunitis, whereas it did not modify the management of patients with responsive celiac disease.

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*	Presented in part at the annual meeting of the American Gastroenterological Association, May 1998, New Orleans, Louisiana.

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Vol 50 - N° 5

P. 613-617 - novembre 1999 Retour au numéro

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Push enteroscopy in celiac sprue and refractory sprue - 08/09/11

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