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Medicine General 6fa36da6

A 12 year old girl has history of recurrent bulky stolls and abdominal pain since 3 year of age. She has moderate pallor and her weight and height are below the 3`d percentile. Which of the following is the most appropriate investigation to make a specific diagnosis?

A
Small intestinal biopsy
B
Barium studies
C
24-hr- fecal fat estimation
D
Urinary d-xylose test
High-Yield Explanation
Answer is A (Small intestinal biopsy): 'Small intestinal mucosal biopsy is essential in the evaluation of a patient with documented steatorrhea or chronic diarrhea (>3 weeks). -- Harrisons Failure to thrive in the background of recurrent bulky stools and abdominal pain suggests a diagnosis of chronic malabsorption. Although all options provided in the question may be used to suppo the diagnosis, the most appropriate investigation to make a specific diagnosis is small intestinal biopsy.

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