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L-5. Endoscopic procedures. ENDOSCOPY. The use of fiber-optic scopes for the purpose of examination, diagnosis, and treatment. Began as a diagnostic tool.
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L-5 Endoscopic procedures
ENDOSCOPY • The use of fiber-optic scopes for the purpose of examination, diagnosis, and treatment. • Began as a diagnostic tool. • Now most scopes are equipped w/ various gizmos for: biopsy, cauterization, and a wide variety of instruments for advanced surgical procedures.
COMPLICATIONS / RISKS • Risk depends on the nature of the procedure and the anesthesia involved. • There are possible 7 risks of any endoscopy. • 1) Perforation. • 2) Aspiration. • 3) Adverse drug reaction. • 4) Cardiovascular problems, arrhythmias. • 5) Bleeding. • 6) Infection. • 7) Reaction to contrast material.
BRONCHOSCOPY • Examination of the trachea and main stem bronchi. • Primary purpose is to diagnose malignancy. • Also used to remove foreign bodies. • Can do biopsies, washings, and brush biopsies. • Can culture for pathogens: Pneumocystis carinii, Legionella. • Done under conscious sedation w/ topical anesthetic, or general anesthesia.
GASTROINTESTINAL ENDODOSCOPY • ESOPHAGOSCOPY- esophagus only. • GASTROSCOPY- esophagus and stomach. • ESOPHAGOGASTRODUODENOSCOPY- esophagus, stomach, & duodenum. • PROCTOSCOPY- anus & rectum. • SIGMOIDOSCOPY- rectum and sigmoid colon. • COLONOSCOPY- rectum and entire colon. • Usually done under conscious sedation, occasionally general
GASTROINTESTINAL ENDODOSCOPY USES • DIAGNOSIS / DETECTION OF: malignancy, ulcers, bleeding, inflammation, etc. • Removal of foreign bodies. • Biopsy of polyps, lesions suspicious for malignancy, etc. • Control of bleeding via cautery, ligation.
ESOPHAGUS IMAGES COMPLIMENTS OF :http://www.gicare.com/pated/ei00001.htm
LOWER ESOPHAGEAL SPHINCTER CLOSED OPEN
NORMAL STOMACH PYLORIS FUNDUS ANTRUM
FOREIGN BODY - STOMACH PEARL EAR-RING
E.R.C.P. • Endoscopic Retrograde Cholangiopancreatography. • Endoscope passed to the duodenum, w/ cannulation of the Ampulla of Vater. • Dye is injected and films taken. • Used to evaluate the patency and integrity of the common bile duct, R/O obstruction, such as w/ stones.
E.R.C.P. • Helpful in the post-cholecystectomy patient who has a post-op complication: stone obstructing the CBD, stricture, etc.
COLONOSCOPY USES • Evaluation of rectal bleeding, abdominal pain, etc.- cancer, polyps, inflammatory bowel disease. • Biopsy of suspicious lesions, polyps, inflammation. • Control of bleeding, banding of hemorrhoids. • Also used as a screening tool for early diagnosis of colon cancer, along w/ rectal exam and test for fecal occult blood.