Celiac disease other imaging findings: Difference between revisions
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[[Image:celiac_3.jpg|left|thumb|200px|[[Endoscopy|Endoscopic]] still of [[duodenum]] of patient with coeliac disease showing scalloping of folds.]] | [[Image:celiac_3.jpg|left|thumb|200px|[[Endoscopy|Endoscopic]] still of [[duodenum]] of patient with coeliac disease showing scalloping of folds.]] | ||
An [[upper endoscopy]] with [[biopsy]] of the [[duodenum]] (beyond the [[duodenal bulb]]) or [[jejunum]] is performed. It is important for the physician to obtain multiple samples (four to eight) from the duodenum. Not all areas may be equally affected; if biopsies are taken from healthy bowel, it would result in false negative results. | An [[upper endoscopy]] with [[biopsy]] of the [[duodenum]] (beyond the [[duodenal bulb]]) or [[jejunum]] is performed. It is important for the physician to obtain multiple samples (four to eight) from the duodenum. Not all areas may be equally affected; if biopsies are taken from healthy bowel, it would result in false negative results. | ||
Most patients with coeliac disease have a small bowel that appears normal on endoscopy; however, five endoscopic findings have been associated with a high specificity for coeliac disease when all are found: scalloping of the small bowel folds (''pictured''), paucity in the folds, a mosaic pattern to the [[mucosa]] (described as a ''cracked-mud'' appearance), prominence of the submucosal blood vessels and a nodular pattern to the mucosa.<ref>{{cite journal | author = Niveloni S, Fiorini A, Dezi R, Pedreira S, Smecuol E, Vazquez H, Cabanne A, Boerr LA, Valero J, Kogan Z, Maurino E, Bai JC. | title = Usefulness of videoduodenoscopy and vital dye staining as indicators of mucosal atrophy of celiac disease: assessment of interobserver agreement | journal = Gastrointestinal Endoscopy | volume = 47 | issue = 3 | pages = 223–229 | year = 1998 | id = PMID 9580349}}</ref> | Most patients with coeliac disease have a small bowel that appears normal on endoscopy; however, five endoscopic findings have been associated with a high specificity for coeliac disease when all are found: scalloping of the small bowel folds (''pictured''), paucity in the folds, a mosaic pattern to the [[mucosa]] (described as a ''cracked-mud'' appearance), prominence of the submucosal blood vessels and a nodular pattern to the mucosa.<ref>{{cite journal | author = Niveloni S, Fiorini A, Dezi R, Pedreira S, Smecuol E, Vazquez H, Cabanne A, Boerr LA, Valero J, Kogan Z, Maurino E, Bai JC. | title = Usefulness of videoduodenoscopy and vital dye staining as indicators of mucosal atrophy of celiac disease: assessment of interobserver agreement | journal = Gastrointestinal Endoscopy | volume = 47 | issue = 3 | pages = 223–229 | year = 1998 | id = PMID 9580349}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Other Imaging findings
Endoscopy
An upper endoscopy with biopsy of the duodenum (beyond the duodenal bulb) or jejunum is performed. It is important for the physician to obtain multiple samples (four to eight) from the duodenum. Not all areas may be equally affected; if biopsies are taken from healthy bowel, it would result in false negative results.
Most patients with coeliac disease have a small bowel that appears normal on endoscopy; however, five endoscopic findings have been associated with a high specificity for coeliac disease when all are found: scalloping of the small bowel folds (pictured), paucity in the folds, a mosaic pattern to the mucosa (described as a cracked-mud appearance), prominence of the submucosal blood vessels and a nodular pattern to the mucosa.[1]
Until the 1970s, biopsies were obtained using metal capsules attached to a suction device. The capsule was swallowed and allowed to pass into the small intestine. After X-ray verification of its position, suction was applied to collect part of the intestinal wall inside the capsule. One much utilized capsule system is the Watson capsule. This method has now been largely replaced by fiberoptic endoscopy, which carries a higher sensitivity rate and a lower error frequency.[2]
References
- ↑ Niveloni S, Fiorini A, Dezi R, Pedreira S, Smecuol E, Vazquez H, Cabanne A, Boerr LA, Valero J, Kogan Z, Maurino E, Bai JC. (1998). "Usefulness of videoduodenoscopy and vital dye staining as indicators of mucosal atrophy of celiac disease: assessment of interobserver agreement". Gastrointestinal Endoscopy. 47 (3): 223–229. PMID 9580349.
- ↑ Mee A, Burke M, Vallon A, Newman J, Cotton P (1985). "Small bowel biopsy for malabsorption: comparison of the diagnostic adequacy of endoscopic forceps and capsule biopsy specimens". Br Med J (Clin Res Ed). 291 (6498): 769–72. PMID 3929934.