59. Investigations in GI? Flashcards
What are the diagnostic indications for an endoscopy?
Haematemesis/melaena Dysphagia Dypepsia and alarm symptoms Duodenal biopsy Persitant vomiting Iron deiciency Treatment of bleeding lesions Variceal of bleeding lesions Variceal bleeding and sclerotherpay Stent insertion Stricture dilatation
What actions need to be carried out before and after an endoscopy
Stop PPI’s 2 weeks prior as they may mask disease
Nil by mouth 6 hours before
Dont drive 24 hours after sedation
What sedations methods are available in an endoscopy?
Midazolam
Local anaesthtic for pharynx
Continous suction to stop aspiration reargless of aaesthesia
What is a sigmoidoscopy?
When is it used?
Views the rectum and distal colon.
PR bleeding= FLEXI SIG!!!!! (THE NUT BUTTON)
Therpatuic for sigmoid volvulus
To take biopsies to investigate symptoms and normal mucosa
What actions need to be carried out before a sigmoidoscopy
PR exam before a procedure
Phosphate enema in prep
What are the indications for a colonoscopy?
Rectal bleeding Iron deficiency aneamia Persistent diarrhoea Positive feacal occult test Positive FIIT test Assessment of IBD Colon cancer surveillance Haemostasis Bleeding angiodysplasia Colonic stent deploymeny Volvulus decompression Pseudoobstruciton
What must be stopped 1 week before colonsocopy?
Iron tablets
What must be carried out before a colonoscopy?
Do a PR first
Sedation
Analgesia
What must be carried out after a colonoscopy?
No alcohol
No machinery for 24 hours
When would a video camera endoscopy be used?
Small bowel pathology
Obscure GI bleeding
What are the two types of liver biopsy?
Percutanous- for normal clotting factors
Transjugular
How is a percutaneous liver biopsy carried out?
Done under USS/CT guidance.
Percuss liver vorder. Explore mid axillary line
Lidocaine
Monitor obs closely throughout
What are the complications of a liver biospy?
Pneumothroax
Bleeding
Pain
Death
