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Also in the pediatric population the digestive endoscopy became, at this point, a very good diagnostic and operative technique largement used. The endoscopy can explore the upper gastrointestinal tract (esophagus, stomach, duodenum and jejunum) and can investigate the colon and the terminal ileum regarding the lower gastrointestinal tract. Principally, the operative endoscopy concerns emostasis of gastrointestinal bleeding, polipectomy, extraction of foreign bodies, and intestinal dilatations. The patients population submitted to this investigation by now is very wide thanks to the modernization of the instruments and at specialization of gastroenterologist pediatricians: range from newborn, to childhood, adolescence and young adults. The gastroenterologist pediatricians specialization associated to a routine use of amnemonic drugs (benzodiazepine) reduced at the minimum the invasivity of endoscopy; this technique can be considered a good safe procedure and free of important physical and psychic side effects for the young patient.

Latent coeliac disease (L.C.D.) is an extremely rare condition to describe. In this study we analyzed three cases of patients affected by L.C.D.: two of them suffered from insulin-dependent diabetes mellitus (IDDM) and the other one from infantile cerebral palsy and eosinophilic gastroenteritis. We confirm the existence of this form of coeliac disease (C.D.), by means of duodenal biopsy, and stress the importance of an early diagnosis in order to prevent the serious consequences caused by untreated C.D.

In this study we report our experience with 50 intestinal biopsies carried out in 35 children in a 14 months period (October 1979-December 1980) and we also describe the technique we use. The biopsy has been performed by two operators using the Crosby capsule, placed at the duodenojejunal flexure under fluoroscopic screening. For sedation we used oral Promazine and viscous xylocaine and i.v. Metoclopramide and Diazepam; the sedation has been classified in 4 degrees and resulted very good in 40 cases, good in 8 cases and sufficient in 2. The biopsy specimens has been examined with dissecting and light microscope and demonstrated 14 sub-total villous atrophy, 2 severe partial villous atrophy, 5 partial villous atrophy and 29 normal villous morphology. By this technique we made a diagnosis of Coeliac disease in 8 cases, suspected Coeliac disease in 3 cases, Dermatitis Herpetiformis in 3 cases and cow's milk proteins intolerance and post-enteritis syndrome in 1 case. No complications occurred during or after intubation. The AA. confirm the diagnostic value of this investigation, its safety and its very high degree of sensitivity superior to any other test of intestinal absorption.

There are some theoretical reasons to give an oral bacterial therapy when intestinal ecosystem changes its composition. The authors would verify the clinical effectiveness or oral bacterial therapy during acute and functional chronic diarrhea: even if the course of the illness doesn't become shorter, oral bacterial therapy moreover may be useful in reducing the risk of having casual carries of pathogenic agents and may restore an intestinal ecosystem previously modified by antibiotic therapy.