SMALL-BOWEL BIOPSY IN SWEDISH PEDIATRIC CLINICS

The capsule technique for small bowel biopsy performed at Swedish paed iatric clinics was evaluated using two questionnaires in 1990 and 1993 , respectively. Replies were received from all 45 centres which togeth er perform approximately 2300 biopsies per year. Clotting function tes ts prior to biopsy were carried out in 42% of the centres. The biopsie s were performed under intubation anaesthesia in 13% of the centres. T he most striking difference between the answers to the two questionnai res was the mode of sedation. The use of intravenous sedatives increas ed from 40% of the centres in the first questionnaire to 59% in the se cond one. The use of the oral, rectal and intramuscular routes decreas ed correspondingly. The most frequently used drugs for intravenous sed ation were benzodiazepines, in the first questionnaire diazepam and in the second one midazolam. The failure rate was approximately 5%. In t he first questionnaire, no complication was encountered. In the second questionnaire, three cases of intramural duodenal haematoma were repo rted, one of which led to pancreatitis. We conclude that by focusing o n questions of sedation these rather simple questionnaires may have re sulted in more effective sedation of children undergoing small bowel b iopsy.