Diagnostic duodenal bulb biopsies in celiac disease

To evaluate duodenal bulb biopsies with respect to histological changes in the diagnosis of celiac disease as compared with biopsies from second part of duodenum. Endoscopic biopsies were obtained from 44 patients [23 females and 21 males] suspected clinically as having celiac disease. Four biopsy samples were obtained from each duodenal bulb and second part of duodenum. The histological changes were reported according to Marsh's classification. The histological changes were equally similar from biopsies of duodenal bulb as compared to second part in all except four patients. Mucosal specimens taken from duodenal bulb and second part of duodenum were strongly correlated histologically