Lutfi A, Khan M A, Sarwar Jehan Zuberi.
Non-Endoscopic Gastric Mucosal Biopsy in Dyspepsia.
J Pak Med Assoc Jan ;53(9):432-3.

Sixty four patients (28 males, 36 females) over the age of 15 years with a clinical diagnosis of dyspepsia, were included in this study. After an over night fast the patient was given one teaspoon full of ENO (Sodium bi carbonate) fruit salt to distend the stomach. Nasopharynx was anaesthetized with Xylocain jelly prior to the nasogastric (NG) tube placement. Then under fluoroscopic guidance a 120 cm resterlizable endoscopy cable biopsy forceps with a needle and nonfenestrated large cup was passed into the stomach through the NG tube. Manual compression with a leaded glove was done to direct the biopsy forcep to the right location. Biopsies taken from the antrum, greater curvature and fundus of the stomach were sent in three different bottles containing 10% buffered formalin for histological diagnosis. All except three patients tolerated the procedure well. One patient with asthma developed dyspnoea and two cases had nasal bleeding from hypertrophied nasal turbinates. One hundred and seventy seven biopsies were taken from three sites (Fundus 57, Greater curvature 61, Antrum 59) in 61 patients. Biopsies were normal in 13 (21%), 42 (69%) had H. pylori positive and 6 (10%) H. pylori negative gastritis. This simple, safe and cost effective fluoroscopic technique was found useful in obtaining gastric biopsies in dyspeptic patients.

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