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Water-immersion technique during standard upper endoscopy may be useful to drive the biopsy sampling of duodenal mucosa in children with celiac disease.
J Pediatr Gastroenterol Nutr. 2009 Oct; 49(4):411-6.JP

Abstract

OBJECTIVE

To evaluate the accuracy of the water-immersion technique during upper endoscopy in recognizing the duodenal villous pattern in a series of children who were undergoing endoscopy to obtain duodenal biopsy for histological analysis.

MATERIALS AND METHODS

The water-immersion technique was performed in 19 children. Endoscopic findings were compared with histology. Results were assessed on per biopsy analysis and per patient analysis, taking into account the worst endoscopic finding in each patient and correlating it with the worst histological diagnosis.

RESULTS

Per biopsy analysis: A total of 57 biopsy specimens were obtained and assessed. The endoscopic duodenal investigation correctly identified 53 areas (93%), which corresponded to histology, giving it an accuracy rate of 93%. Per patient analysis: The worst histology of the duodenal bulb was predicted by endoscopy in 18 of the 19 enrolled patients (95%), whereas the worst histopathological lesion of the second portion of the duodenum was recognized in 100% of cases. On the whole, therefore, the endoscopist suggested a diagnosis of celiac disease in 11 patients, with both positive and negative predictive values of 100%.

CONCLUSIONS

The water-immersion technique during upper endoscopy is highly accurate in recognizing the duodenal villous pattern in subjects who need a duodenal investigation. Our findings encourage a cost-saving and patient-retaining approach to the diagnosis of celiac disease by driving biopsy and reducing the number of duodenal samplings.

Authors+Show Affiliations

Department of Internal Medicine, Agostino Gemelli University Hospital, Endoscopy Unit, Institute of Histopathology, Catholic University of Medicine and Surgery, Rome, Italy. gcammarota@rm.unicatt.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Validation Study

Language

eng

PubMed ID

19581815

Citation

Cammarota, Giovanni, et al. "Water-immersion Technique During Standard Upper Endoscopy May Be Useful to Drive the Biopsy Sampling of Duodenal Mucosa in Children With Celiac Disease." Journal of Pediatric Gastroenterology and Nutrition, vol. 49, no. 4, 2009, pp. 411-6.
Cammarota G, Cazzato A, Genovese O, et al. Water-immersion technique during standard upper endoscopy may be useful to drive the biopsy sampling of duodenal mucosa in children with celiac disease. J Pediatr Gastroenterol Nutr. 2009;49(4):411-6.
Cammarota, G., Cazzato, A., Genovese, O., Pantanella, A., Ianiro, G., Giorgio, V., Montalto, M., Vecchio, F. M., Larocca, L. M., Gasbarrini, G., & Fundarò, C. (2009). Water-immersion technique during standard upper endoscopy may be useful to drive the biopsy sampling of duodenal mucosa in children with celiac disease. Journal of Pediatric Gastroenterology and Nutrition, 49(4), 411-6. https://doi.org/10.1097/MPG.0b013e318198ca88
Cammarota G, et al. Water-immersion Technique During Standard Upper Endoscopy May Be Useful to Drive the Biopsy Sampling of Duodenal Mucosa in Children With Celiac Disease. J Pediatr Gastroenterol Nutr. 2009;49(4):411-6. PubMed PMID: 19581815.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Water-immersion technique during standard upper endoscopy may be useful to drive the biopsy sampling of duodenal mucosa in children with celiac disease. AU - Cammarota,Giovanni, AU - Cazzato,Alessia, AU - Genovese,Orazio, AU - Pantanella,Adriano, AU - Ianiro,Gianluca, AU - Giorgio,Valentina, AU - Montalto,Massimo, AU - Vecchio,Fabio M, AU - Larocca,Luigi M, AU - Gasbarrini,Giovanni, AU - Fundarò,Carlo, PY - 2009/7/8/entrez PY - 2009/7/8/pubmed PY - 2010/5/15/medline SP - 411 EP - 6 JF - Journal of pediatric gastroenterology and nutrition JO - J Pediatr Gastroenterol Nutr VL - 49 IS - 4 N2 - OBJECTIVE: To evaluate the accuracy of the water-immersion technique during upper endoscopy in recognizing the duodenal villous pattern in a series of children who were undergoing endoscopy to obtain duodenal biopsy for histological analysis. MATERIALS AND METHODS: The water-immersion technique was performed in 19 children. Endoscopic findings were compared with histology. Results were assessed on per biopsy analysis and per patient analysis, taking into account the worst endoscopic finding in each patient and correlating it with the worst histological diagnosis. RESULTS: Per biopsy analysis: A total of 57 biopsy specimens were obtained and assessed. The endoscopic duodenal investigation correctly identified 53 areas (93%), which corresponded to histology, giving it an accuracy rate of 93%. Per patient analysis: The worst histology of the duodenal bulb was predicted by endoscopy in 18 of the 19 enrolled patients (95%), whereas the worst histopathological lesion of the second portion of the duodenum was recognized in 100% of cases. On the whole, therefore, the endoscopist suggested a diagnosis of celiac disease in 11 patients, with both positive and negative predictive values of 100%. CONCLUSIONS: The water-immersion technique during upper endoscopy is highly accurate in recognizing the duodenal villous pattern in subjects who need a duodenal investigation. Our findings encourage a cost-saving and patient-retaining approach to the diagnosis of celiac disease by driving biopsy and reducing the number of duodenal samplings. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/19581815/Water_immersion_technique_during_standard_upper_endoscopy_may_be_useful_to_drive_the_biopsy_sampling_of_duodenal_mucosa_in_children_with_celiac_disease_ L2 - https://doi.org/10.1097/MPG.0b013e318198ca88 DB - PRIME DP - Unbound Medicine ER -