Abstract
Radiological and endoscopic examination for upper gastrointestinal and colon diseases has become routine according to recent advances in radiography and fiberoptic instrumen-tation. However, a current preoperative diagnosis of the small intestine remains difficult because of limitations of the usual endoscopic method. Up to date, small intestinal endoscopy has been developed along three main lines; (1) a push-type fiberscope, (2) a rope-way-type fiberscope and (3) a sonde-type fiberscope. In our clinic, the sonde-type endoscope (SSIF, Olympus) which resembles a Miller-Abbott or Cantor tube was applied to 73 patients during the last six years. According to our devices in instrumentation of SSIF, a recent insertion rate into the distal part of the small intestine has been becoming much better and various small intestinal lesions could be diagnosed endoscopically. Although SSIF had neither a biopsy channel nor an angulation mechanism, it could be inserted into the distal part of the small intestine in a short time without any hazard. Moreover, narrow or stenotic lesions which would interfere with passage of the push-type scope or the transintestinal string, were amenable to examination by SSIF. A disadvantage of SSIF is lack of a biopsy channel. However, one of out recent ideas on SSIF enables us to devise an aspiration apparatus for obtaining intestinal fluid. Testing the intestinal fluid for occult blood helped to localize sources of bleeding and was also valuable for bacterial and immunological studies. Therefore, with further improvement of SSIF and the insertion technique, we will be able not only to inspect all parts of the small intestinal mucosa and to diagnose lesions more easily, but also to approach to the patho-physiological aspect of the small intestine.
