| Abstract: | From 1968 to 1975 532 intestinal suction biopsies were obtained in 371 children and adolescents using the paediatric Watson capsule. The youngest patient was 2 months old; a 9 months old infant has the lowest body weight of 3 520 g. Mucosal specimens were mainly taken from the upper jejunum. The whole procedure mostly required not more than 30 minutes. No serious complications were seen. Due to technical troubles several attempts were ineffective; the rate of successful biopsies was 89%. The paediatric Watson capsule proved to be easy to handle, mostly reliable, and therefore very suitable for intestinal biopsy in childhood. The dissecting microscope and histological findings were classified into four groups: normal mucosa, slight, moderate and severe mucosal lesions. Severe lesions were almost only demonstrated in patients with coeliac disease: in the active phase, in the early phase of remission under gluten free diet and during gluten loading or normal diet respectively, furthermore in an infant with protracted diarrhoea and in a child with agammaglobulinemia. A flat mucosa is not pathognomonic for coeliac disease but a constant morphological attribute and conclusive for diagnosis. Moderate mucosal lesions were seen in the remission of coeliac disease or during gluten loading and in some cases with protracted diarrhoea of infancy and with chronic malabsorption of unknown origin, furthermore in a child with immunoglobulin deficiency and in another one with iron deficiency anemia. The examination with the dissecting microscope can be performed very easily and makes obvious a very exact diagnostic information which is completed by the histological examination. |
