Caps in GI Endoscopy

Question

What is the best way to inspect the papilla of Vater in the abscence or lack of availability of a duodenoscope (side-viewing scope, ERCP scope)?

Answer

Today we present a useful tip for inspection of the papilla of Vater using distal transparent cap.

A close and detailed inspection of the major papilla may be needed in a variety of clinical situations, for example, during upper endoscopy of a patient with a familial polyposis syndrome (FAP) or duodenal adenomas Although some papillae may be seen well with forward-viewing instruments, many are partially or fully hidden behind duodenal folds and, therefore, are outside the field of view of a standard upper endoscope. Using a distal transparent cap allows visualization and inspection of virtually every major papilla without having to resort to the use of a second endoscope—that is, a duodenoscope. See attached figure.