English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Tools annual

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Presents the access of premium content as premium feature

Premium Content

Global: Zendy Plus annual

Global: Zendy Free Plan

Background: Esophagogastroduodenoscopy (EGD) is an essential diagnostic test in children with gastrointestinal diseases. Small bowel biopsies (SBB) are usually collected from the distal duodenum. A duodenal bulb biopsy (DBB) is recommended in children with celiac disease (CD), because up to 8% can have exclusive bulb injury. This study aims to assess the benefit of separate bulb biopsy in children who underwent EGD and had DBB performed. Methods: We reviewed the electronic medical records between 011998 and 05-2014. All children who underwent an EGD with separate DBB were included. Demographic, clinical, and histopathological parameters were recorded. Results: A total of 211 children were identified. The average age was 10 years (range 1-17 years). Fifty-eight patients had CD, and 153 were non-CD. All patients with CD had positive celiac serology, whereas in non-CD, 10 had positive serology (5 TTG IgG with negative TTG IgA, 1 TTG IgA, and 4 DGP IgG with normal villous architecture). In patients with CD, DBB was diagnostic in 2 (3%) with exclusive bulb injury and confirmatory in 3 (5%) with partial villous atrophy in the bulb and only increased intraepithelial lymphocytes (IEL) distally. In the non-CD group, 7 (4.5%) patients had exclusive bulb injury (4 peptic duodenitis and 3 IEL). Conclusions: In children with CD, DBB increased the diagnostic yield by 9%. In the non-CD group, isolated bulb injury was found in 4.5%, with unclear clinical significance suggesting that DBB may carry higher specificity to CD.

The Benefit of Separate Bulb Biopsy in Children Undergoing an Esophagogastroduodenoscopy