OBSERVATION METHOD AND SIGNIFICANCE OF THE DEEP DUODENUM

Abstract

The environment in the duodenal mucosa has changed due to the increase in the eradication rate of Helicobacter pylori and the improvement of gastric acid secretion. In addition, due to the development of endoscopic equipment and technology, the detection of duodenal lesions has recently been increasing. Many duodenal lesions are detected in the descending part of the duodenum; however, duodenal lesions may also be present in the transverse part and ascending part. The transverse and ascending parts of the duodenum are referred to as the deep duodenum, which is sometimes difficult to reach with routine esophagogastroduodenoscopy (EGD). The deep duodenum can be observed by balloon-assisted endoscopy (BAE) and capsule endoscopy (CE), and it is expected that the chances of observation of the deep duodenum will increase more and more as new operations of the upper gastrointestinal endoscope are devised. Although the deep duodenum should be observed as much as possible by routine EGD, it is difficult to reach this part of the duodenum in many cases. Therefore, it is necessary to clarify the purpose of each examination and select the appropriate modality.