How safe is small bowel biopsy?

This retrospective, controlled study covers data from the medical records of 298 hospitalized patients, who, during the period 1972-1982, had 1,007 hydraulic small bowel biopsies removed on 342 occasions. The main complication was hemorrhage (drop in hemoglobin concentration greater than or equal to 2 g/100 ml) in 1.5% of the investigations. In one case (0.3%) transfusions were required. One other patient (0.3%) needed laparotomy following perforation. No deaths due to jejunal biopsy were observed in our series. Four patients (1.2%) developed transient temperature greater than or equal to 38 degrees C in response to the biopsy. The final diagnosis 'small bowel bacterial overgrowth' in three of these patients suggests that bacteremia was the cause of postbiopsy fever, and that bacterial overgrowth predisposes to this complication of jejunal biopsy. Neither the number of biopsies (n = 1-20), nor the performance of repeat investigations in the same patient, nor the year of investigation, nor nutritional status showed any correlation to the development of complications.