Usefulness of jejunal biopsy in the study of intestinal malabsorption in the elderly.
BACKGROUND
small bowel structure and function are not different between elderly people and young people. Thus, in principle it is advisable to perform diagnostic investigation of elderly patients as well as younger patients when they present with symptoms suggestive of intestinal malabsorption. A key test for the etiologic diagnosis of intestinal malabsorption, jejunal biopsy, has not been specifically examined to assess its usefulness and risk of complications in this advanced age patients.


OBJECTIVE
to establish the usefulness of jejunal biopsy with the Watson's capsule in the elderly patients with suspected intestinal malabsorption.


METHODS
patients older than 65 years referred to our Unit for performance of a jejunal biopsy from 1996 to 2001 for suspicion of intestinal malabsorption.


RESULTS
forty-seven patients were included. Appropriate biopsy sample was obtained in 45 cases, although in 3 patients a second try was required. Histologic findings: partial villous atrophy in 10 cases (22.2%), complete villous atrophy in 5 cases (11.1%), intraepithelial lymphocytosis in 5 cases (11.1%), and single cases of intestinal lymphangiectasia, amyloidosis, unspecific jejunitis, and Whipple's disease. Histology was normal in 19 cases (42%). Definitive diagnosis was celiac disease in 14 patients, bacterial overgrowth in 3, jejunitis in 3, Whipple's disease in 1, lymphangiectasia in 1, atrophic gastritis in 3, amyloidosis in 1, and ischemic colitis in 1. Jejunal biopsy achieved an etiologic diagnosis in 20 patients. There were no cases of perforations or bleeding.


CONCLUSIONS
jejunal biopsy is a useful and safe test for the etiologic diagnosis of intestinal malabsorption in elderly patients.
Lobo
B
B
Service of Digestive Diseases, University Hospital Vall d'Hebron, Barcelona, Spain.
Casellas
F
F
de Torres
I
I
Chicharro
L
L
Malagelada
J R
JR
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D006801:Humans; D007583:Jejunum / Q000473:pathology*; D008286:Malabsorption Syndromes / Q000473:pathology*; D008297:Male; D011446:Prospective Studies