| Gastral antral biopsy in the differentiation of pediatric colitides. | |
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MedLine Citation:
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PMID: 12650787 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Differentiation of Crohn's disease (CD) from ulcerative colitis (UC) is problematic, primarily when inflammation is confined to the colon. In a historical cohort study, we evaluated the usefulness of baseline gastric antral biopsies in the differentiation of pediatric chronic colitides. METHODS: During initial investigation for suspected inflammatory bowel disease, 39 children and adolescents with colitis but normal small bowel radiography underwent pretreatment upper endoscopy concurrently with colonoscopy. Two reviewers assigned a colonoscopic diagnosis (colonic CD, UC, or indeterminate colitis) based on the macroscopic and microscopic appearances of the colonic mucosa. Antral histological findings were compared between groups using Fisher's exact test. RESULTS: Five (14%) of colonoscopic diagnoses (four indeterminate, one UC) were changed to CD by the finding of granulomatous inflammation in antral biopsies. Nonspecific antral gastritis was found in similar proportions of children and adolescents with Crohn's colitis and UC (92% vs 75%). Focal antral gastritis was more common in patients with Crohn's colitis than UC (52% vs 8%). CONCLUSIONS: Nonspecific antral gastritis is common in all forms of chronic colitis. Nevertheless, upper gastrointestinal endoscopy with biopsy is useful in the differentiation of inflammatory bowel disease confined to the colon, particularly when colonoscopic findings are indeterminate. |
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Authors:
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P S Kundhal; M O Stormon; M Zachos; J N Critch; E Cutz; A M Griffiths |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 98 ISSN: 0002-9270 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2003 Mar |
Date Detail:
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Created Date: 2003-03-24 Completed Date: 2003-04-10 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 557-61 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Division of Gastroenterology and Nutrition, The Hospital for Sick Children, University of Toronto, Toronto, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Biopsy Child Colitis / pathology* Diagnosis, Differential Female Granuloma Humans Inflammation Male Pyloric Antrum / pathology* |
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