Gastral Antral Biopsy in the Differentiation of Pediatric Colitides

Abstract

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.

Diagnostic Value of Esophagogastroduodenoscopy in Patients with Ileal Pouch–Anal Anastomosis

“…Granulomas on antral biopsy can be diagnostically conclusive for CD, while focal antral gastritis was more common in CD than in UC. 1 It should be pointed out that chronic antibiotic use was common in patients with IPAA. Therefore, Candida esophagitis on EGD came with no surprise.…”

“…21 It appears that in patients with CD, duodenal biopsies more often yield granulomas than colonic biopsy. [21][22][23] 2) Potential diagnostic value in patients with a diagnosis of IC-upper GI tract involvement may suggest a diagnosis of CD, rather than UC, 24 although upper GI inflammation such as diffuse duodenitis in UC has been reported in the pathology literature 25 . 3) Evaluation for concomitant peptic ulcer disease, NSAID-induced gastropathy, or enteropathy, celiac disease, 26,27 or other small bowel pathology such as eosinophilic enteritis, 28 common variable immune deficiency, 29 and small bowel neoplasia.…”

“…Biopsies of mucosa of the upper GI tract in patients with indeterminate colitis (IC) may be helpful in making a diagnosis of Crohn's colitis. 1,2 The same procedure may deliver therapeutic intervention in terms of bleeding control and dilatation of stricturing disease. 2 The role of EGD evaluation of the upper GI tract comorbidities in patients with ileal pouches has not been investigated.…”

Role of Endoscopy in Diagnosis of Crohn’s Disease and Chronic Ulcerative Colitis

“…Nonspecifi c chronic infl ammation in the stomach was found in roughly equal proportions (75-92 %) of CD and UC, although focal antral gastritis was much more common in CD (52 %) compared to UC (8 %). Five (14 %) of patients had a diagnosis change from UC or indeterminate colitis to CD based on EGD fi ndings of granulomatous gastritis [ 6 ]. There is limited long-term data regarding the endoscopic UGI fi ndings in confi rmed UC patients and therefore, the clinical signifi cance and outcomes of these fi ndings is unknown.…”

“…Furthermore, there is a report of duodenitis on EGD in a symptomatic patient with established UC following colectomy [ 5 ]. Kundhal reported upper GI fi ndings in 39 children with suspected IBD colitis and normal small bowel radiographs [ 6 ]. Nonspecifi c chronic infl ammation in the stomach was found in roughly equal proportions (75-92 %) of CD and UC, although focal antral gastritis was much more common in CD (52 %) compared to UC (8 %).…”