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The Old Endoscopy Quiz (and Answer) of the Month May 2006

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Question:
Click on an image to get a magnification! - and then click "Back"
If You do a lot of upper endoscopies You probably see a finding like this every week. However typical this is, it might not be so easy to recognize it when seen for the first or second time. This young student came to an upper endoscopy because of problems with intestinal gas and a slight diarrhea. She had earlier been found to suffer from lactose intoleranse, which is quite common in our country. This was the finding in the descending part of her duodenum. The biopsy taken in the last image - what will it show?
Answer:
The biopsy showed villous atrophy - and so the diagnose is Coeliac Disease.
Correct answers and comments were emailed by
Dr Virendra Parikh, Fort Wayne, USA, Indiana
Antonio Siqueira, Brasilia, Brasil
ARBER VELIU, PRISHTINA, KOSOVO
Zahreddine Radwan, Beirut, Lebanon
Salvatore Della Ducata, Gallipoli, Italy
Daniel Gelfond, Baltimore, Maryland
Björn Lindkvist, Gothenbourg, Sweden
Claudia Iacobescu, Bucharest, Romania
Cevale Karslioglu Sgouros, Istanbul, Turkey
Dr.khalid Ahmed Bamakhrama, DUBAI, UAE
ricardo latorre, Santiago, Chile
German Lloret Salom, Alzira, Spain
Ma³gorzata Ferenc, Olsztyn, Poland
PARABOLI SILVA, Marcio Luiz , SAO JOSE DO RIO PRETO-SP- BRAZIL
mehmet, Istanbul, Turkey
Jebnoun, Tunis, Tunisia
Klaudia jadwiga Niepsuj, Gliwice, Poland
JAMSHID, DUBAI, UNITED ARAB EMIRATES
 Montreal, Canada, in the night
Haissam Nourallah, Montreal, Canada
Ellie Pongratz, Bowie, MD
MARCUS HADDAD FILHO, RIO DE JANEIRO, BRASIL
Ahmet Faruk Ašan, Istanbul, Turkey
Amrani Khalil, Constantine, Algeria
muharrerm Taskoparan, ADANA, TURKEY
Ho Dang Quy Dung, Choray Hospital, Ho Chi Minh city, Viet Nam
wanglei, Chongqing, China
Vassiliki Arvaniti, Piraeus, Greece
Alberto, Milan, Italy
erin, west newbury, ma
Meemee, New York, NY, USA
STOLL, Saverne, France
F Desbazeille, Orléans, France
maria balas, Le Mans, France
Xavier Lesage, Lille, France
Papalavrentios Lavrentios, Thesaloniki, Greece
Eduardo Puelma E., Santiago, Chile
Kat, Brooklyn, USA
SRIDHAR Subbaramiah, AUGUSTA, Georgia, USA
Lorna Kirkham, Milton Keynes, U K
Sophie, Saint-Etienne, France
Shannon Facer, Bountiful, Utah, USA
Dr Munir Bishara, Melbourne, Victoria, Australia
Tahi Riad, Algiers, Algeria
Jarek Basaj, Warszawa, Poland
Patsy Benhart, Iowa city, Iowa
Hiam Mustafa, Khartoum, Sudan
Leela Arthur, Brisbane, Australia
Eduardo, Porto Alegre, RS Brasil
Manuel, Buenos Aires, Argentina
hisham, London, UK
Aaron Thornton, Melbourne, Australia
yassir khiyar, Hull, UK
Ervin Toth, Malmö, Sweden
Robert Popken, Carvoeiro, Portugal
Bernadette bryceland, UK
Petr.Vozeh, Prag, českį republika
Anastasios Koulaouzidis, Liverpool, UK
Carlos Escobar, Medellin, Colombia
U Cuartas, Augusta, GA ,USA
Melissa Detrick, Reno, Nevada, USA
Sue Gritt, Winchester, UK
Comments:
Intraepithelial lymphocytes, with inflamatory changed - suggestive of Celiac Diseas - would check TTG levels and consider Gluten Free diet.

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