Intestinal Biopsy

This CIBA Symposium on the intestinal mucosa represents a timely review of dissecting, light, and electron microscopic studies of the small bowel. Booth, et al. describes dissecting microscopic changes in the small bowel, some of which could not be appreciated by the light microscope. The dissecting microscope appears to be widely employed by the British and Europeans, but neglected by the Americans. The electron micrographs by Shiner, Lacy, and Hudson of the mucosa in normal individuals and in patients with idiopathic steatorrhea are excellent. These authors also trace the absorption and passage of fats through the cells. Other electron micrographs are presented by Rubin, et al. demonstrating improvement in mucosal epithelial cell pathology on glutenfree diets. The toxic effects of gluten on the intestine of patients with idiopathic steatorrhea are well demonstrated by Anderson and Townley. Rubin also reviews and extends his earlier work which revealed that the major pathological changes are in the proximal bowel, but that ideal lesions can be induced by putting gluten into the ileum. Dr. Fraser's interesting contribution on the significance of mucosal damage attempts to correlate the location of mucosal injury with various parameters of absorption, as well as to explore the effects of the various wheat fractions on the mucosa. The final article on tropical sprue by Baker and co-workers would seem to indicate that there are some differences in the mucosal architecture found in tropical and non-tropical sprue, but of even greater interest was the fact that so-called "normal people" in South India may have "abnormal" biopsies. This little book provides a concise compilation of available data on the technique and use of intestinal biopsies. Such faults as needless repetition in certain areas and lack of information on histochemical studies are more than overcome by good illustrations, numerous references, and an excellent index. It should be a useful addition to the library of physicians interested in the pathophysiology of the small intestine.