The potentials of intestinoscopy and guided biopsy in the diagnosis of diseases of the small intestine

AIM: To ascertain the role of intestinoscopy in diagnosis of small intestinal diseases. MATERIALS AND METHODS: Intestinoscopy with multiple topographic biopsies was made with SIF-10 device (Olympus) in 92 patients. RESULTS: Of 60 patients with absorption disorders, the diagnosis of gluten enteropathy (GEP), Whipple's disease (WD), general variable hypogammaglobulinemia (GVHG) and small intestinal diverticulum was established in 38, 3, 5 and 1 patients, respectively. 13 patients with mild malabsorption were free of the pathology. GEP, amyloidosis, intestinal lymphangiectasia were found in 5, 3 and 4 of 15 patients with exudative enteropathy. The rest had lymphoma, lymphangiomatosis, Crohn's disease. 11 patients with focal affections had Crohn's disease, polyps, GVHG or had only motor defects. Repeated intestinal hemorrhages in a few patients were due to adenocarcinoma, aberrant pancreas, intestinal or gastric erosions. CONCLUSION: Patients with malabsorption and exudative enteropathy had similar abnormalities in the small intestine and duodenum. Endoscopic biopsy from the distal duodenum is enough for diagnosis of GEP, Whipple's disease and GVHG. Intestinoscopy as well as x-ray imaging are effective in detection of focal lesions of the small intestine and sources of intestinal bleeding.