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
Answer is A. 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.