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Value of duodenal endoscopic markers of villous atrophy.
J Med Liban. 2001 Nov-Dec; 49(6):319-24.JM

Abstract

Several endoscopic aspects of duodenal mucosa have been described in patients with villous atrophy (VA) and celiac disease. We assessed the accuracy of three endoscopic markers in patients referred for duodenal biopsy.

METHODS

From January 1992 to June 2000 all patients undergoing upper gastrointestinal (UGI) endoscopy by a single operator (n = 4102), had the second part of the duodenum examined, without any magnification technique or addition of vital dye staining, for the presence of three markers of VA, (1) reduction or loss of Kerkring's folds, (2) scalloped configuration of the duodenal folds, and (3) mosaic appearance of the mucosa. Biopsy samples were taken from those in whom the mucosa was abnormal (n = 51), and from those in whom it was normal but where biopsy was indicated (n = 230).

RESULTS

None of the 230 endoscopically normal controls had VA. Seven out of 51 patients (14%) with an abnormal mucosa had a normal histology, the remaining 44 (86%) had some degree of VA confirmed at histology, partial VA in 11 patients (25%) and subtotal or total VA in 33 patients (75%). 63% of the patients with only one endoscopic marker had VA confirmed at histology whereas the coexistence of more than one marker was always associated with histological villous atrophy. The overall sensitivity, specificity, positive and negative predictive values of the endoscopic markers were respectively, 100%, 97%, 86%, and 100%.

CONCLUSION

The appearance of the second part of the duodenal mucosa as assessed during routine UGI endoscopy, is a sensitive and specific indicator of the presence of VA on biopsy, and should alert the endoscopist to the possibility of a celiac disease.

Authors+Show Affiliations

Division of Gastroenterology, Saint George's Hospital, Beirut, Balamand University, Lebanon.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12744633

Citation

Aoun, J P., et al. "Value of Duodenal Endoscopic Markers of Villous Atrophy." Le Journal Medical Libanais. the Lebanese Medical Journal, vol. 49, no. 6, 2001, pp. 319-24.
Aoun JP, Moukarbel N, Aftimos G. Value of duodenal endoscopic markers of villous atrophy. J Med Liban. 2001;49(6):319-24.
Aoun, J. P., Moukarbel, N., & Aftimos, G. (2001). Value of duodenal endoscopic markers of villous atrophy. Le Journal Medical Libanais. the Lebanese Medical Journal, 49(6), 319-24.
Aoun JP, Moukarbel N, Aftimos G. Value of Duodenal Endoscopic Markers of Villous Atrophy. J Med Liban. 2001 Nov-Dec;49(6):319-24. PubMed PMID: 12744633.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Value of duodenal endoscopic markers of villous atrophy. AU - Aoun,J P, AU - Moukarbel,N, AU - Aftimos,G, PY - 2003/5/15/pubmed PY - 2003/6/11/medline PY - 2003/5/15/entrez SP - 319 EP - 24 JF - Le Journal medical libanais. The Lebanese medical journal JO - J Med Liban VL - 49 IS - 6 N2 - UNLABELLED: Several endoscopic aspects of duodenal mucosa have been described in patients with villous atrophy (VA) and celiac disease. We assessed the accuracy of three endoscopic markers in patients referred for duodenal biopsy. METHODS: From January 1992 to June 2000 all patients undergoing upper gastrointestinal (UGI) endoscopy by a single operator (n = 4102), had the second part of the duodenum examined, without any magnification technique or addition of vital dye staining, for the presence of three markers of VA, (1) reduction or loss of Kerkring's folds, (2) scalloped configuration of the duodenal folds, and (3) mosaic appearance of the mucosa. Biopsy samples were taken from those in whom the mucosa was abnormal (n = 51), and from those in whom it was normal but where biopsy was indicated (n = 230). RESULTS: None of the 230 endoscopically normal controls had VA. Seven out of 51 patients (14%) with an abnormal mucosa had a normal histology, the remaining 44 (86%) had some degree of VA confirmed at histology, partial VA in 11 patients (25%) and subtotal or total VA in 33 patients (75%). 63% of the patients with only one endoscopic marker had VA confirmed at histology whereas the coexistence of more than one marker was always associated with histological villous atrophy. The overall sensitivity, specificity, positive and negative predictive values of the endoscopic markers were respectively, 100%, 97%, 86%, and 100%. CONCLUSION: The appearance of the second part of the duodenal mucosa as assessed during routine UGI endoscopy, is a sensitive and specific indicator of the presence of VA on biopsy, and should alert the endoscopist to the possibility of a celiac disease. SN - 0023-9852 UR - https://www.unboundmedicine.com/medline/citation/12744633/Value_of_duodenal_endoscopic_markers_of_villous_atrophy_ L2 - https://medlineplus.gov/celiacdisease.html DB - PRIME DP - Unbound Medicine ER -