RESUMEN
Small bowel biopsy is essential for the diagnosis of malabsorption and recently endoscopic inspection of duodenal mucosa was reported to be helpful in diagnosing cocliac disease. In a study of 214 patients suspected to have malabsorption, we compared the diagnostic yield of endoscopic appearance, dissecting microscopy and histopathology of small bowel biopsies. The endoscopic appearance was abnormal in 64%, 20.3%, 66.6% and dissecting microscopy showed abnormalities in 68.5%, 26.5% and 83.3% in celiac disease, tropical sprue and primary intestinal lymphoma respectively, reflecting the site of lesions in the small bowed in these disorders. Moreover, in organic causes of malabsorption the endoscopic appearance and dissecting microscopy showed a predictive value of 100% and 94.3% respectively. There was no statistical difference between both procedures in all the groups studied. It seems that endoscopic inspection of the duodenal mucosa and dissecting microscopy examination of the biopsy is safe, rapid, easy and reliable procedure in the diagnosis and differentiation of various syndromes of malabsorption