Jejunal biopsy with the Watson capsule and perforation in the elderly.

Details of jejunal biopsies using the Watson small intestinal biopsy capsule done from 1966 through 1976 at three centers in Liverpool were obtained. The only complications were jejunal perforation which occurred in 2 patients over 65 years of age, 1 of whom died. This increased risk in elderly does not appear to have been previously recognized and both cases are reported. Diagnostic yield in the age group over 65 is discussed. Stricter criteria in selection of these patients for biopsy are suggested. A period of in-patient observation after biopsy in those over the age of 65 may decrease the risks of perforation. In addition, the use of a pediatric capsule, ideally with controlled suction, may lessen the risk further. The use of duodenal biopsy via an endoscope may prove to be a useful additional technique in elderly patients.