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The Old Endoscopy Quiz (and Answer) of the Month February 2003

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Question:
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Coeliac Disease - also known as gluten-sensitive enterophathy - is a much more common disease than generally expected. The true prevalence in many countries might be as high as 1 in 100. Most of these patients are asymptomatic, and the diagnose is made only when complications occur, if ever. In order to avoid complications like osteoporosis or small bowel malignancies this disease should be found and treated when still in an asymptomatic state.
Histologic examination of biopsies from the small intestine mucosa is the gold standard for the diagnosis of this disease. A preliminary diagnosis can often be made during upper endoscopy, where the finding in the descending part of the duodenum is quite typical.
The six images above are all from the descending part of the duodenum. Three of the images are from patients with coeliac disease, and three from persons without any digestive disorders.
Which three are from coeliac patients?
Answer
Images 1, 4 and 6 show mucosal changes due to coeliac disease
Correct answers and comments were emailed by
dongjun fan, taiyuan, china
Yaşar Nazlıgül, Ankara, TÜRKİYE
Kubilay Cinar, Ankara, Turkey
Ulrike Hurler, Heidenheim, Germany
Martin Merenda, Novı Jièín
Dr.Virendra Parikh, FORT WAYNE, INDIANA, USA
Peter Rebhan, Trondheim, Norway
LOTFI AISSAOUI, ARAR, SAUDIA ARABIA
Christian Nielsen, Vasa, Finland
tiffany West, Elk River, USA, MN
Fred Stam, Haarlem, Holland
German Lloret-Salom, Alzira, España
wang yong jun, jinan, china
leigh, birmingham, west mids, UK
dr bhagwan thakur, Bombay, India
 The flag of Colombia
luisguillermoguerrero, Bogota, Colombia
jorge ferreiro, st paul, mn usa
FUAD, PASIC, TUZLA, BOSNIA
Ervin Toth, Malmoe, Sweden
haissam nourallah, new mowasat hospital, kuwait
Moutaz Derbala, Cairo, Egypt
Yekta Kişioğlu, Istanbul, Turkey
 Pigeon Rocks, Beirut, Lebanon
Zahreddine Radwan, Beirut, Lebanon
S. Buderus,53347 Alfter, Germany
Rogerio Godinho, Almada, Portugal
Tommy Holmström, Mariehamn, Aland,Finland
Mary, Osage, Mitchell, IA
FUAD PASIC, DOHA, QATAR
Arber Veliu, Prishtina, Kosovo
Curt Tysk, Orebro, Sweden
Abdón Guerra, San Antonio, CHILE
Mihai Ciocirlan, Bucharest, Romania
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