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    Presentation of Upper GI Endos

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    Haqmal
    Upper GI endoscopy indication and preparation 1388 : UPPER GI ENDOSCOPY INDICATION AND PREPARATION ESOPHAGOGASTRODUODENOSCOPY OR GASTROSCOPY DEFINATION: DIRECT VISUAL EXAMINATION OF THE UPPER GASTROINTESTINAL TRACT BY MEANSOF A FLEXIBLE FIBEROTIC ENDOSCOPE. LOOK FOR: ULCER , EROSTION , POLYP , STRICTURES , MALIGNANCY ,VARICES , BLEEDING SITE. EQUIPMENT ENDOSCOPY TYPES 1. 2. 3. 4. Rigid GI endoscopy Semiflexible endoscopy Fiberoptics endoscopy ERCP ( endoscopic retrograde cholangeo

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    Presentation of Upper GI Endos

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    Haqmal
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    Upper GI endoscopy indication and preparation 1388 : UPPER GI ENDOSCOPY INDICATION AND PREPARATION ESOPHAGOGASTRODUODENOSCOPY OR GASTROSCOPY DEFINATION: DIRECT VISUAL EXAMINATION OF THE UPPER GASTROINTESTINAL TRACT BY MEANSOF A FLEXIBLE FIBEROTIC ENDOSCOPE. LOOK FOR: ULCER , EROSTION , POLYP , STRICTURES , MALIGNANCY ,VARICES , BLEEDING SITE. EQUIPMENT ENDOSCOPY TYPES 1. 2. 3. 4. Rigid GI endoscopy Semiflexible endoscopy Fiberoptics endoscopy ERCP ( endoscopic retrograde cholangeo

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    Presentation of Upper GI Endoscopy

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    Upper GI endoscopy indication and preparation 1388 : UPPER GI ENDOSCOPY INDICATION AND PREPARATION ESOPHAGOGASTRODUODENOSCOPY OR GASTROSCOPY DEFINATION: DIRECT VISUAL EXAMINATION OF THE UPPER GASTROINTESTINAL TRACT BY MEANSOF A FLEXIBLE FIBEROTIC ENDOSCOPE. LOOK FOR: ULCER , EROSTION , POLYP , STRICTURES , MALIGNANCY ,VARICES , BLEEDING SITE. EQUIPMENT ENDOSCOPY TYPES 1. 2. 3. 4. Rigid GI endoscopy Semiflexible endoscopy Fiberoptics endoscopy ERCP ( endoscopic retrograde cholangeo

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT or read online from Scribd
    Download as ppt
    740 views44 pages

    Presentation of Upper GI Endos

    Uploaded by

    Haqmal
    Upper GI endoscopy indication and preparation 1388 : UPPER GI ENDOSCOPY INDICATION AND PREPARATION ESOPHAGOGASTRODUODENOSCOPY OR GASTROSCOPY DEFINATION: DIRECT VISUAL EXAMINATION OF THE UPPER GASTROINTESTINAL TRACT BY MEANSOF A FLEXIBLE FIBEROTIC ENDOSCOPE. LOOK FOR: ULCER , EROSTION , POLYP , STRICTURES , MALIGNANCY ,VARICES , BLEEDING SITE. EQUIPMENT ENDOSCOPY TYPES 1. 2. 3. 4. Rigid GI endoscopy Semiflexible endoscopy Fiberoptics endoscopy ERCP ( endoscopic retrograde cholangeo

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    Download as PPT or read online from Scribd
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    Upper GI endoscopy indication and

    preparation

    1388 :‫سال‬
    UPPER GI ENDOSCOPY
    INDICATION AND PREPARATION
    • ESOPHAGOGASTRODUODENOSCOPY OR
    GASTROSCOPY
    • DEFINATION:
    • DIRECT VISUAL EXAMINATION OF THE UPPER
    GASTROINTESTINAL TRACT BY MEANSOF A FLEXIBLE FIBEROTIC
    ENDOSCOPE.

    • LOOK FOR:
    • ULCER , EROSTION , POLYP , STRICTURES ,
    MALIGNANCY ,VARICES , BLEEDING SITE.

    • EQUIPMENT
    ENDOSCOPY TYPES
    1. Rigid GI endoscopy
    2. Semiflexible endoscopy
    3. Fiberoptics endoscopy
    4. ERCP ( endoscopic retrograde cholangeo
    pancreatography
    5. Digital endoscopy
    6. Endoscopic ultrasound
    7. Capsule endoscopy
    Capsule endoscopy

    1. Capsule
    2. Receiving and storing system
    3. Workstation for image integration( into
    video) and analysis
    INDICATION FOR UER GI
    ENDOSCOPY
    High yield indication
    1. Acute upper GI bleeding
    2. Disphagia
    3. Dispepsia (refractory anti refux)
    4. Odinophagia
    5. Surveillance endoscopy ( barrett`s esophagitis ,
    lye-induced strictures , plummer – vinson syndrome )
    6. Abnormalities seen on upper GI serios
    7. Suspected gastric outlet obstruction
    INDICATION FOR UPPER GI
    ENDOSCOPY
    • Lower yield indication( procedure not
    always appropriate)
    1. Atypical chest pain
    2. Abdominal pain of unknown etiology
    3. Routine uncomplicated case of
    gastroesophageal reflux
    4. Uncompplicated case of duodenal ulcers
    Therapeutic indication for EGD
    1. Sclerotherapy of bleeding esophageal varices
    2. Management of upper GI bleeding
    3. Laser ablation of esophageal cancer
    4. Endoscopic placement of esophageal stints
    5. Placement of permanent feeding tubes
    under endoscopic guidance
    6. Dilatation of esophageal st‫ق‬uictures
    7. Polypectomy
    8. Dissolution of bezoars
    Contraindication

    1. Acute myocardial infarction


    2. Hypoxiemia respiratory distress
    3. Hypotension and shock regardless of
    etiology
    4. Massive upper GI bleeding with
    hypotension
    5. Uncontrolled hypertension
    6. Patient refusal
    Relative contraindications(high risk
    situations) include:
    1. Noncorrectable coagulopathy
    2. Recent myocardial infarction
    3. Severe coronary artery disease
    4. Recent upper GI tract surgery where
    anastomotic sites may still be fresh
    5. Active peritonitis
    6. Subluxation or instability of the cervical spine
    7. Anterior cervical spine osteophytes
    8. PERFORATED VISCUS
    9. Zenker`s diverticulum
    PATIENT PREPARATION
    1. Understanding of the patient particular clinical
    problem
    2. An awareness of the patient`s clinical history
    3. A knowledge of the patient`s recent and post
    medication history
    4. What procedure specific preparation is required
    5. What patient specific preparation is required
    6. Informed consent
    7. Post procedure observation and discharge
    planning
    Pre procedural preparation
    • Preparation for endoscopy
    • Preparation for ERCP
    • Preparation for endoscopic ultrasound
    • Preparation for capsule endoscopy
    • Preparation for endoscopic procedure in patient
    with diabetes.
    • Preparation for endoscopic in case of ingestion of
    a foreign bodies or for food bolus obstruction
    • Preparation for endoscopic in patient with upper
    GI bleeding
    • Sedation
    Procedural monitoring

    • Level of consciousness
    • Pulmonary ventilation
    • Pulse oximetry
    • Homodynamic measurement
    • Supplemental oxygen
    Post procedural monitoring
    1. Not to drive
    2. Not to operate heavy dangerous machinary
    3. Not to sign any legally documents
    4. To arrange escort home with an able
    companion
    5. Written instruction regarding the sign and
    symptoms of any advise outcome of the
    procedure and contact numbers for 24 hours
    advice.
    complications
    1. Perforation of esophagus or stomach (0.1%)
    2. Bleeding ( 0.03%)
    3. Cardiopulmonary complications
    significant cardiac arrhythmias, ischemic change,
    pulmonary aspiration (0.08%)
    4. Toxicity of premedication (local phlebitis, transient
    nausea , respiratory depression.)
    5. Infections ( bacteremia , infective endocarditis)
    Drugs for sedation
    1. Rapid onset of action
    2. Practical means of delivery
    3. Short half life with rapid recovery
    sedative
    4. Safe with predictable response
    (pharmacodynamic)
    5. Effective producing action, pain free,
    cooperation patient.
    Drugs for sedation

    • Benzodiazepines
    1. Midazolam
    2. diazepam
    • Opiates
    1. Meperidine
    2. Fentanyl
    • Propofol in deep sedation
    • Pharyngeal anasthesia
    Antibiotics prophylaxis

    1. Synthetic vascular grafts


    2. Patient with prosthetic join
    3. Endoscopic percutaneus gastrostomy
    4. Valvular heart disease
    5. Ascitis cirrhosis immunocompramised
    patients
    Usual antibiotics

    • Ampicillin gentamycin amoxicillin


    voncomycin
    Esophageal varice
    Esophageal white pill obstruction
    Gastric ulcer with bleeding
    ERCP STONE IN DUODENUM
    Gastric erosion
    Esophageal varices
    ERCP intrahepatic biliary duct
    dilatation
    Normal endoscopy
    Ultrasound endoscopy

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