Clinical Gastroenterology Vol.25 No.8(4)

Theme Magnifying Endoscopy -- Is It Really Necessary for All the Endoscopists?
Title Zoom Endoscopy for Small Intestine and Duodenum
Publish Date 2010/07
Author Kazuo Ohtsuka Digestive Disease Center, Showa University, Northern Yokohama Hospital
Author Kenta Kodama Digestive Disease Center, Showa University, Northern Yokohama Hospital
Author Haruo Ikeda Digestive Disease Center, Showa University, Northern Yokohama Hospital
Author Noriyuki Ogata Digestive Disease Center, Showa University, Northern Yokohama Hospital
Author Hiroshi Kashida Digestive Disease Center, Showa University, Northern Yokohama Hospital
Author Shin-ei Kudo Digestive Disease Center, Showa University, Northern Yokohama Hospital
[ Summary ] Zoom endoscopy is very effective for esophageal, stomach and colorectal diseases. Those types of endoscopies are primarily used to observe pit patterns or vessel patterns in the mucosa. Other important subjects for enteroscopy in the small intestine are villi. Zoom enteroscopes are not available at this time. However, water emersion methods produce effects similar to zoom enteroscopy. Narrow Band Imaging also makes close examinations possible. Chromoendoscopy with methylene blue or crystal violet are also helpful. Normal villi have bright zones on their surface, and loop vessels inside. There are irregular red swollen villi of various sizes, with dilated vessels also seen in epithelial tumors. Heterotopic gastric mucosa are observed in the bulb of the duodenum. The characteristic findings of adenocarcinoma in the papilla of the duodenum are dilated and winding vessels of various sizes and heterogeneous mucosal patterns. Though the significance of zoom enteroscopy remains unsure, it should be clarified through future studies.
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