Value of rectosigmoidoscopy with biopsies for diagnosis of inflammatory bowel disease in children

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 co...

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Bibliographic Details
Published in:Inflammatory bowel diseases 2002-01, Vol.8 (1), p.16-22
Main Authors: Escher, Johanna C., ten Kate, Fiebo, Lichtenbelt, Klaske, Schornagel, Irene, Büller, Hans, Derkx, Bert, Taminiau, Jan
Format: Article
Language:English
Subjects:
Adolescent
Age Factors
Biopsy
Biopsy, Needle
Child
Child, Preschool
Children
Colon - diagnostic imaging
Colon - pathology
Colon, Sigmoid - diagnostic imaging
Colon, Sigmoid - pathology
Colonoscopy
Crohn's disease
Diagnostic accuracy
Female
Histology
Humans
Ileocolonoscopy
Ileum - diagnostic imaging
Ileum - pathology
Infant
Inflammatory bowel disease
Inflammatory bowel diseases
Inflammatory Bowel Diseases - diagnostic imaging
Inflammatory Bowel Diseases - pathology
Male
Radiography
Rectosigmoidoscopy
Rectum
Rectum - diagnostic imaging
Rectum - pathology
Reproducibility of Results
Ulcerative colitis
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Summary: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.
ISSN:1078-0998
1536-4844
DOI:10.1097/00054725-200201000-00003