SIGNIFICANCE OF ENDOSCOPY/COLONOSCOPY VERSUS MICROSCOPY IN PATIENTS WITH CHRONIC DIARRHEA

Aurangzeb Khan, Walayat Shah, Munaza A. Khan, Muhammad Junaid Khan, S. Agha Ali Shah

Department of Pathology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar - Pakistan

Abstract

Objective: To know the relative significance of endoscopy/colonoscopy and microscopy in patients presenting with chronic diarrhea.

Material and Methods: Between May 2012 and September 2013 about 90 patients with chronic diarrhea turning up at Gastroenterology Department (major study group) of Hayatabad Medical Complex (HMC) and Post Graduate Medical Institute (minor study group) Lady Reading Hospital, Peshawar (PGMI, LRH), were selected as a study group. These included patients with an age range of 1.5 years to 80 years and with a mean age of 27 years. Biopsies were
obtained from both the visibly normal as well as affected portions of the intestine in all these patients. The patients were, therefore, categorized into groups on the basis of gender and the procedure they had undergone. All had undergone either endoscopy or colonoscopy. The results of the two procedures (endoscopy or colonoscopy) were then mutually compared with microscopy of the biopsies.

Results: Fifty-three (58.89%) were having grossly normal-appearing mucosa on endoscopy/ colonoscopy, while the remaining patients 37 (41.11%) showed some abnormality on inspection. In contrast to this, the grossly normal-appearing mucosa on endoscopy/colonoscopy was actually not as normal on microscopy as might have been thought.
On microscopy (histopathology) only 6 (6.67%) were normal. In the rest of 84 (93.33%) patients some degree of abnormality was observed.

Conclusion: These findings are clearly suggestive of the relative more importance of performing random biopsies even in macroscopically normal appearing small intestine and colon and hence suggestive of the relatively more importance of microscopy over endoscopy/ colonoscopy in diagnosis of chronic diarrhea.

Keywords: Chronic, diarrhea, Microscopy, Endoscopy, Colonoscopy

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