title: Value of rectosigmoidoscopy with biopsies for diagnosis of inflammatory bowel disease in children.
abstract: BACKGROUND
  In children with inflammatory bowel disease (IBD), treatment depends on the type and extent of disease. Therefore, maximal effort should be made to provide a correct diagnosis. The aim of this study was to assess the value of a histologic diagnosis made on the basis of either ileal and colonic or rectosigmoid biopsies.
  
  
  METHODS
  In 42 children with a known diagnosis of IBD, biopsies from rectum and sigmoid were reassessed by an expert, blinded pathologist. This histologic diagnosis was compared with the diagnosis based on (ileo)colonic biopsies and the final diagnosis.
  
  
  RESULTS
  In patients with IBD, diagnostic accuracy of rectosigmoid histology was 0.4524. For (ileo)colonic biopsies, diagnostic accuracy was 0.7619.
  
  
  CONCLUSIONS
  Histology on biopsies from rectum and sigmoid is insufficient for a correct diagnosis of Crohn's disease or ulcerative colitis in children. At initial presentation, an ileocolonoscopy with biopsies should therefore be performed in all children.
authors.affiliation: Department of Pediatric Gastroenterology, Emma Children's Hospital, University of Amsterdam, The Netherlands. johanna.escher@tch.harvard.edu
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Escher
authors.forename: Kate Fiebo
authors.initials: KF
authors.lastname: ten
authors.forename: Klaske
authors.initials: K
authors.lastname: Lichtenbelt
authors.forename: Irene
authors.initials: I
authors.lastname: Schornagel
authors.forename: Hans
authors.initials: H
authors.lastname: Büller
authors.forename: Bert
authors.initials: B
authors.lastname: Derkx
authors.forename: Jan
authors.initials: J
authors.lastname: Taminiau
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology*; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging / Q000473:pathology*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging / Q000473:pathology*; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D011859:Radiography; D012007:Rectum / Q000000981:diagnostic imaging / Q000473:pathology*; D015203:Reproducibility of Results