Bronchoesophagoscopy

1. Bronchoesophagoscopy VyronAtienza

2. Definition • Examination of the tracheobronchial tree and esophagus through appropriate endoscopes

3. Esophagoscopy • Flexible esophagoscopy • local anesthesia, generally well tolerated • allows for concomitant examination of the stomach and duodenum. • preferred by internists. • Rigid esophagoscopy • can also be performed under local anesthesia but it is more comfortable for the patient and examiner to conduct the procedure under general endotrachealanesthesia • Better when looking for foreign bodies, because the advancing rigid scope tends to flatten out the mucosal lining, making it easier to detect trapped foreign objects

4. PREPARING FOR ESOPHAGOSCOPY • Fast for about four hours before esophagoscopy • You should have a relative to take you home afterwards as you will be given a sedative. • Lozenges to suck which contain a local anesthetic to numb your throat. • Eliminatesthe gag reflex and enables the esophagoscope to be passed without discomfort. • Back of your throat may be sprayed with a local anesthetic. Any dentures are removed.

6. Tracheoscopy • visualizing the inside of the airways for diagnostic and therapeutic purposes. • An instrument is inserted usually through the nose or mouth, or occasionally through a tracheostomy. • Examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation.

7. Purposes • Diagnostic • To view abnormalities of the airway • To obtain tissue specimens of the lung in a variety of disorders. • Bleeding in the lungs, possible lung cancer, a chronic cough, sarcoidosis • Therapeutic • To remove secretions, blood, or foreign objects lodged in the airway • Laser resection of tumors or benign tracheal and bronchial strictures • Stent insertion to palliate extrinsic compression of the tracheobronchial lumen from either malignant or benign disease processes • Bronchoscopy is also employed in percutaneoustracheostomy • Tracheal intubation of patients with difficult airways is often performed using a flexible bronchoscope

8. Types • Rigid bronchoscopy • retrieving foreign objects • Massive hemoptysis, defined as loss of >600 mL of blood in 24 hours. • The larger lumen of the rigid bronchoscope versus the narrow lumen of the flexible bronchoscope allows for therapeutic approaches such as electrocautery to help control the bleeding

9. Types • Flexible bronchoscope • longer and thinner than a rigid bronchoscope. • Flexible bronchoscopy causes less discomfort for the patient than rigid bronchoscopy and the procedure can be performed easily and safely under moderate sedation. • It is the technique of choice nowadays for most bronchoscopic procedures.