Small intestinal capsule biopsy under endoscopic guidance

Abstract

Small intestinal mucosal biopsy is of recognized value in the evaluation of suspected malabsorption. 1-3 Conventional techniques of peroral suction capsule jejunal biopsy are often time consuming and generally require fluoroscopy and special positioning of the patient to guide the capsule through the pylorus. Efforts to facilitate the technique of small intestinal biopsy have resulted in the development of a steerable peroral suction biopsy apparatus and the use of endoscopic duodenal forceps biopsy.5, 6 The former technique is cumbersome because it requires the use of fluoroscopy. On the other hand, the endoscopic forceps biopsy usually results in crushed tissue, which is not as suitable as the suction capsule specimen for histological interpretation. Graham et al. l recently described the use of a modified Quinton capsule under endoscopic guidance in pediatric patients. Using a less complex apparatus, we have adopted an endoscope/capsule technique of small bowel biopsy that is rapid, does not require fluoroscopy, and provides a high yield of suitable biopsy material.