A 6-Year-Old Girl Is Brought to the Office Due to Intermittent

A 6-year-old girl is brought to the office due to intermittent abdominal cramps, bloating, and diarrhea for 2 months.  She also has excessive flatulence, which typically occurs after meals.  The patient has had no fever or vomiting.  She eats a well-balanced diet and takes no medications or vitamins.  Vital signs are appropriate for age.  Examination shows a mildly distended abdomen with no hepatosplenomegaly or tenderness.  Laboratory evaluation reveals elevated tissue transglutaminase antibodies.  Which of the following locations should be biopsied to confirm the diagnosis in this patient?

A) Stomach
B) Duodenum
C) Distal jejunum
D) Terminal ileum
E) Colon

Correct Answer:

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