Abstract
Although recommended, RF to evaluate the rectal vault is not always practiced in endoscopy. A previous study of 75 LGI endoscopies found that RF increased the diagnostic yield in distal rectum but a larger study of 453 subjects concluded that retroflex view (RV) did not produce additional information compared with straight view (SV) examination. Both studies did not detect any adenomatous polyps using this maneuver. This study was done to evaluate if RF increased the diagnostic yield compared with SV examination of the rectal vault. Methods: This prospective study included 600 consecutive patients undergoing diagnostic colonoscopy or flexible sigmoidoscopy. The rectal vault was first inspected carefully upon withdrawal of the endoscope. The scope was then readvanced into the rectum and retroflexed to view the vault. The scope was then straightened and a second look on SV at withdrawal was done. Endoscopic findings of the different views were noted. All polyps ≥ 5mm in size were biopsied. Results: The procedure was performed successfully in 592 patients (8 had contracted vault). Excluding internal hemorrhoids and polyps
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