Crosby Small-intestinal Capsule with Radio-opaque Tube and Latex Sheath.

We have met four technical difficulties when using the Crosby biopsy capsule (Crosby and Kugler, 1957): 1 difficulty in localizing the capsule in the alimentary tract; 2 occasional difficulty in withdrawing the capsule through the pylorus; 3 loss of the dome of the capsule in the intestine; 4 uncertainty as to whether the capsule has 'fired'. These difficulties have been overcome in the following ways. LOCALIZATION The Odman-Ledin red arterial catheter (approximately 1 mm. bore and 2 mm. diameter) is sufficiently radio-opaque to show plainly on radiographs of the abdomen FIG. 1. Radiograph showing Crosby capsule in small intestine. (Fig. 1). It has the additional advantage of being rigid enough to help introduction into the throat and to prevent coiling in the throat. It does not kink in the alimentary tract, and if indented by the patient's teeth, the marks may be removed by immersing the tube in water at 70°C. for one minute and then hanging the tube vertically until cool. The tube described by Cox (1963) is less radio-opaque and lacks the other advantages. WITHDRAWAL Intravenous injection of 15 mg. propantheline bromide in 10 ml. of normal saline will relax pyloric spasm within a few minutes. The dome of the capsule sometimes comes apart from the capsule in the patient's intestine. To prevent this, the manufacturers provide a spring clip to hold the dome in place, but with this there is always a possibility of tearing the mucosa during withdrawal of the capsule. We have replaced this spring clip by a latex sheath which holds the dome firmly and covers the edges of the diaphragm (Fig. 2).1 This ensures a streamlined surface 'The latex sheath was originally made by one of us (R.H.S.) but it is now manufactured by Eschmann Bros. and Walsh Ltd. and is available from The Genito-Urinary Manufacturing Company, 28a Devon-FIG. 2. Details of the latex sheath. A The spring clip (above) and the latex sheath which replaces it. B The latex sheath slipped up the tube so that the Crosby capsule can be taken apart. C The latex sheath in position over the capsule ready for use.