Endoscopic examination of a normal Z-line
To begin with, the area of the Z-line is rinsed free, and the Z-line is then visualized. Esophageal motility repeatedly obstructs viewing.
The Z-line is visualized without enhancement and with iScan. Spasticity in the distal esophagus is obstructing good visualization of the Z-line here. Air is therefore suctioned out of the stomach, so that a better view of the Z-line is obtained during withdrawal.
1% acetic acid is used to demonstrate the surface structure. An attempt is made to visualize the surface structure of the Z-line despite motility.
Using a distancing cap, the mucosa is spread apart to allow better visualization of mucosal details in individual areas along the circumference. The whitish acetic acid staining makes the surface structure more visible, and a short tongue of Barrett’s appears on the left. Macroscopically, the rest of the Z-line has gastric mucosa on it.
Complete examination of the Z-line includes visualizing it in the inverted position. The Z-line is relatively low here.