impedance pH reflux episode
impedance pH study used for diagnosis of GERD
A pediatric colonoscope
A pediatric colonoscope facilitates intubation of the jejunal limbs, particularly the afferent limb, after gastrojejunostomy.
Retroflex the endoscope
Retroflex the endoscope to visualize the cardia. A. Perform this maneuver by deflecting the tip sharply back. An owl’s eye view of both pylorus and cardia may be seen as the tip crosses over the incisura. B. As the cardia is identified, move the tip in a
The second portion of the duodenum
The second portion of the duodenum is recognized by its concentric semicircular folds.
The Pylorus
The pylorus is viewed from the gastric antrum. The endoscope is gently advanced while keeping the pylorus directly in the center of the visual field. Sometimes the pylorus will be observed to open and close. Position the endoscope ready to pass through th
Advancing the Endoscope
As the endoscope is advanced, the lumen is kept in view. A gentle upward deflection of the tip helps the endoscope hug the lesser curvature.
Patient Positioning
With the patient in the left lateral decubitus position, the endoscopist facing the patient, and the scope relaxed as described in the text, entry into the stomach will generally give a view oriented with the lesser curvature at 12 o’clock, the greater cu
Upper Gastrointestinal Endoscopy
A. The endoscope is advanced down the relatively straight esophagus until the lower esophageal sphincter is identified. B. The lower esophageal sphincter often coincides with the transition from squamous epithelium (white) of the esophagus to mucosa (pink
The esophageal Opening
The esophageal opening is recognized as a simple slit at the base of the triangle formed by the glottis, just behind the arytenoid cartileges. The two piriform sinuses lie on each side of the esophageal opening.
