Case 6, Answer 3c

A good option. If you are confident that Roxy's disease is confined to the GI tract, endoscopy is a much less invasive procedure than abdominal exploratory, and wound healing would be less of a concern. However, endoscopically obtained biopsy samples may not be diagnostic or, if segmental intestinal disease is present, the affected area of intestine may not be reached. In a perfect world, I would recommend an abdominal ultrasonographic examination first to evaluate the extent of Roxy's disease and assess whether she would be a good endoscopy candidate. Multiple endoscopic biopsy samples are recommended, and the intestine should be evaluated to the full length that the scope will allow.

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