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Video Capsule Endoscopy - Sprue, Small Intestine

abstract

This capsule study was performed on this 56 year old man with crampy abdominal pain, complaining of 2 loose stools per day, but no hematochezia, or weight loss. The SBFT and CT scan showed abnormal small bowel loops raising the possibility of sprue. The capsule study demonstrated the classic saw-too...

thed pattern of sprue with an otherwise featureless mucosa. The biopsy shows a flattened duodenal mucosa that looks like colonic mucosa with increased numbers of chronic inflammatory cells in the upper half of the mucosa. Higher power of the surface shows numerous chronic inflammatory cells, mainly lymphocytes, infiltrating the epithelium and causing surface injury. Anti-gliadin and anti-endomysial antibodies studies were also positive and thus the patient was started on a gluten free diet The patient had a prompt clinical response and remains well.

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