USE OF GASTROSCOPE FOR EVALUATION AND TREATMENT OF LESIONS IN THE PROXIMAL JEJUNUM

INTRODUCTION

Small bowel is a difficult area to visualize with endoscopy. While ileo-colonoscopy can help visualize the terminal few centimeters of the ileum, esophagogastroduodenoscopy is usually utilized to view the gastrointestinal tract till the proximal duodenum. The visualization of distal duodenum, jejunum and ileum requires advanced techniques. While capsule endoscopy can provide the visualization of the entire small bowel, it is costly and cannot be used to obtain tissue for histology or for therapeutic purpose. Enteroscopic techniques like the push enteroscopy, spiral enteroscopy and single or double balloon enteroscopy are used to diagnose and treat small bowel lesions¹. However, these are costly and their availability is scarce as is the expertise in their use. The accessories for their use are different and add to the cost of therapy. Previously the use of pediatric colonoscopes has been reported for push enteroscopy². However, the more readily available adult colonoscope may not be helpful because of the larger diameter. We hypothesized that the gastroscope may be used to access the proximal jejunal lesions.