Colonoscopic retroflexion in the evaluation of rectal disease

Although previously described and advocated, rectal retroflexion has not been well studied as a diagnostic maneuver. We report 75 cases in which the maneuver was performed during colonoscopy or fibersigmoidoscopy. The technique was both easily performed by the examiner and well tolerated by patients. Rectal retroflexion increased diagnostic yield in six of 75 patients. It proved a useful adjunct to the standard forward-view of the rectum in the evaluation of internal hemorrhoids and in the detection of small perirectal polyps and rectal inflammatory bowel disease. Excluding patients with severe proctitis or a contracted rectal vault, rectal retroflexion is a valuable technique for the evaluation of suspected rectal disease.