Endoscopic and histopathologic changes in the proximal intestine in adult patients with chronic diarrhoea

ABSTRACT

This study comprises a group of 24 cases with chronic or recurrent diarrhoea who were admitted to the Department of Tropical Medicine, Assiut University Hospital. Upper endoscopy demonstrated subtle [in 17 cases] to gross [in 7 cases] changes. Cases with chronic diarrhoea and normal endoscopic findings were not included in the report. Hisotpathologic examination revealed abnormalities in villous architecture as well as the cellular components of the lamina propria in the 7 cases with gross endoscopic changes and in another 7 cases with subtle changes. The final diagnosis in these 14 cases were T.B. enteritis [11 cases], intestinal lymphoma [2 case] and coeliac disease [1 case]. Chronic non specific cellular infiltration in the lamina propria was detected in 6 cases and mild eosinophilic infiltration in another 2 cases, all 8 had mild jejunal mucosal hyperaemia. Diarrhoea was attributed to liver cirrhosis in the former cases and to amoebiasis in the other 2 cases. There remains 2 cases with mild jejunal mucosal hyperaemia that had normal histologic appearance of the jejunal mucosa and the aetiology of diarrhoea was difficult to settle save, being an associate to-irritable bowel syndrome. The use of sterilized peroral colonoscope helped in diagnosis of upper intestinal lesions, allow for biopsy and brought to light the aetiology in most cases with chronic diarrhoea in adults. The contribution of histopathology was indispensable