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Small bowel biopsy in Swedish paediatric clinics

Stenhammar, L; Ascher, H; Danielsson, L; Dannaeus, A; Hernell, O; Ivarsson, A; Lindberg, E; Lindquist, B and Nivenius, Kerstin LU (2002) In Acta Pædiatrica 91(10). p.1126-1129
Abstract
Aim: A correct diagnosis of coeliac disease, one of the most common chronic diseases in Swedish children, demands small bowel biopsy, which can be performed endoscopically or by means of a peroral capsule. Recently there was a debate among Swedish paediatric gastroenterologists, with some advocating the cessation of capsule biopsy in favour of endoscopic biopsies. To gain information on which to base a recommendation for which technique to use, the Swedish Working Group for Childhood Coeliac Disease was commissioned to carry out a national questionnaire study on current small bowel biopsy routines in Swedish paediatric clinics. Methods: A questionnaire concerning biopsy routines in the year 2000 was sent to all paediatric clinics... (More)
Aim: A correct diagnosis of coeliac disease, one of the most common chronic diseases in Swedish children, demands small bowel biopsy, which can be performed endoscopically or by means of a peroral capsule. Recently there was a debate among Swedish paediatric gastroenterologists, with some advocating the cessation of capsule biopsy in favour of endoscopic biopsies. To gain information on which to base a recommendation for which technique to use, the Swedish Working Group for Childhood Coeliac Disease was commissioned to carry out a national questionnaire study on current small bowel biopsy routines in Swedish paediatric clinics. Methods: A questionnaire concerning biopsy routines in the year 2000 was sent to all paediatric clinics performing biopsies. A reply was obtained from 39 of 40 clinics, covering 98% of the Swedish population. Results: Some 1400 biopsies were performed, 64% of which were capsule biopsies and 36% endoscopic. Three clinics performed all biopsies endoscopically and 11 clinics all via a capsule. At endoscopy all children were under deep sedation or full anaesthesia, while most children undergoing capsule biopsy were under light or deep sedation. The oxygen saturation was monitored during endoscopy but less often or never during routine capsule biopsy. The presence of the parents during biopsy varied according to the degree of sedation: at 97% of the clinics performing capsule biopsy on children under light sedation, the parents were present during the whole procedure, whereas no parents were present at clinics where the biopsy was performed endoscopically under anaesthesia. Conclusion: Compared with the results of a similar questionnaire concerning biopsy routines performed in the early 1990s, children are now more effectively sedated. Furthermore, there is an obvious trend from capsule towards endoscopic biopsy. Both the endoscopic and the capsule biopsy techniques are useful and satisfactory for obtaining small bowel mucosal samples providing that the children are effectively sedated. For practical and economic reasons the capsule biopsy technique will probably continue to be used, although to a lesser extent than today. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
coeliac disease, sedation, small bowel biopsy
in
Acta Pædiatrica
volume
91
issue
10
pages
1126 - 1129
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • pmid:12434901
  • wos:000178271000020
  • scopus:0036401559
ISSN
1651-2227
language
English
LU publication?
yes
id
5091460d-8540-4b05-9280-ea54f54b5066 (old id 327746)
alternative location
http://www.ingentaconnect.com/content/tandf/spae/2002/00000091/00000010/art00020
date added to LUP
2007-11-09 12:21:58
date last changed
2017-08-06 04:27:03
@article{5091460d-8540-4b05-9280-ea54f54b5066,
  abstract     = {Aim: A correct diagnosis of coeliac disease, one of the most common chronic diseases in Swedish children, demands small bowel biopsy, which can be performed endoscopically or by means of a peroral capsule. Recently there was a debate among Swedish paediatric gastroenterologists, with some advocating the cessation of capsule biopsy in favour of endoscopic biopsies. To gain information on which to base a recommendation for which technique to use, the Swedish Working Group for Childhood Coeliac Disease was commissioned to carry out a national questionnaire study on current small bowel biopsy routines in Swedish paediatric clinics. Methods: A questionnaire concerning biopsy routines in the year 2000 was sent to all paediatric clinics performing biopsies. A reply was obtained from 39 of 40 clinics, covering 98% of the Swedish population. Results: Some 1400 biopsies were performed, 64% of which were capsule biopsies and 36% endoscopic. Three clinics performed all biopsies endoscopically and 11 clinics all via a capsule. At endoscopy all children were under deep sedation or full anaesthesia, while most children undergoing capsule biopsy were under light or deep sedation. The oxygen saturation was monitored during endoscopy but less often or never during routine capsule biopsy. The presence of the parents during biopsy varied according to the degree of sedation: at 97% of the clinics performing capsule biopsy on children under light sedation, the parents were present during the whole procedure, whereas no parents were present at clinics where the biopsy was performed endoscopically under anaesthesia. Conclusion: Compared with the results of a similar questionnaire concerning biopsy routines performed in the early 1990s, children are now more effectively sedated. Furthermore, there is an obvious trend from capsule towards endoscopic biopsy. Both the endoscopic and the capsule biopsy techniques are useful and satisfactory for obtaining small bowel mucosal samples providing that the children are effectively sedated. For practical and economic reasons the capsule biopsy technique will probably continue to be used, although to a lesser extent than today.},
  author       = {Stenhammar, L and Ascher, H and Danielsson, L and Dannaeus, A and Hernell, O and Ivarsson, A and Lindberg, E and Lindquist, B and Nivenius, Kerstin},
  issn         = {1651-2227},
  keyword      = {coeliac disease,sedation,small bowel biopsy},
  language     = {eng},
  number       = {10},
  pages        = {1126--1129},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Acta Pædiatrica},
  title        = {Small bowel biopsy in Swedish paediatric clinics},
  volume       = {91},
  year         = {2002},
}