Advanced equine duodenoscopy technique

Duodenal pathologies are underreported in equine medicine, probably not due to little occurrence, but due to the limitations of current diagnostic techniques. The aim of this report is to describe a novel duodenoscopic approach, that allows a complete visualization of a region inaccessible via standard techniques. Gastroduodenoscopy was performed in a clinical setting in 60 adult horses referred to us due to complaints suspected to be related to gastroduodenal diseases. The initial steps of the procedure were performed using previously published techniques. Once the video-endoscope reached the cranial duodenum and before direct visualization of the major duodenal papilla, a slow and controlled retroflexion maneuver was performed, allowing a complete examination of the duodenal face of the pyloric sphincter and the whole cranial aspect of the duodenum. The technique described allowed better duodenoscopy examination, without risking lesions of the adjacent mucosa and allowed a wide field of view avoiding blind spots.