Endoscopic examination of the duodenal bulb: clinical evaluation of forward- and side-viewing fibreoptic systems in 200 cases

Abstract

SUMMARY Two-hundred fibreoptic examinations of the duodenal bulb were carried out on 149 patients. The importance of combining the initial examination with a general endoscopic survey of the oesophagus and stomach is stressed. At the present time full examination of the duodenal bulb requires the use of both a side-viewing and forward-viewing endoscope in more than a quarter of cases. The safety and acceptability to the patient of multiple endoscopic examinations carried out as an outpatient procedure has been demonstrated, and the value of the procedure in x-ray negative dyspepsia, in the follow up of ulcer therapy, and in acute upper gastrointestinal haemorrhage has been shown.

British Society for Digestive Endoscopy

“…There was a disagreement of 49 % between the radiological and endoscopic findings. This figure is higher than that reported by others (McColl, 1972;Salmon et al, 1972;Cotton, 1973). The disagreement between radiology and endoscopy was highest in differentiating gastric ulcer from gastric carcinoma and in this situation the radiological evidence was erroneous in 46%.…”

Fibreoptic endoscopy and the barium meal--results and implications.

“…To ensure an adequate survey in all patients, it is necessary to have available both a forward viewing fully flexible panendoscope (ACMI Model 7089P or Olympus Model GIFD) and a lateral viewing duodenoscope (Olympus Model JFB). Although Salmon et al 3 have compared the use of forward and lateral viewing optical systems in the duodenal bulb, no clinical series is available concerning the overall results of properly equipped routine oesophagogastroduodenoscopy. This paper reviews our recent experience of upper gastrointestinal fibreoptic endoscopy in relation to radiology to try to identify the cases in which endoscopy is of particular diagnostic value.…”

Routine Endoscopic and Radiological Examination of the Duodenum: Analysis of Diagnostic Value and Influence of Duodenoscopy Upon the Choice of Treatment

“…Even though the endoscopic examination of the duodenum in cases with limited space may be improved by using two types of duodenoscope, side-viewing and forward-viewing respectively (1,16), the present analysis emphasizes that the diagnostic accuracy is increased by performing an endoscopic as well as a radiographic examination.…”