endoscope Flashcards
technique for using
endoscope controls- left hand
endoscope tip- right arm
what are endoscopes used for
diagnosis- both benign and malignant
therapeutics- emergency or elective
screening
surveillance- picking up cancer of the bowel early
specialised types of endoscope
gastroscope colonoscope side viewing scope enteroscope capsule endoscopic ultrasound
visual diagnosis
oesophagitis gastritis ulceration coeliac disease chrohns disease ulcerative colitis sclerosing cholangitis
what often causes gastritis
anti-inflammatory tablets
treating ulcers
caused by H.Pylori treated using antibiotics amoxicillin clarithromycin or metronidazole
first line use a PPI- acts on the acid which would aggravate the ulcer already formed
miscellaneous conditions identified by endoscope
Mallory-Weiss tears diverticulae foreign bodies (food bolus, razor blades) stones worms
why endoscope good for early diagnosis
can diagnose pre-malignant conditions
ability to remove tissue in a minimally invasive way
easy to follow up
screening
angiodysplasia
growth of new blood cells
so close to the lumen that endoscope can cause bleeding very easy
types of bleeding
variceal bleeding
arterial bleeding
angiodysplasia
treating variceal bleeding
this is a life threatening medical emergency ABC resuscitate injection- fibrinogen banding histocryl glue
varicose bleeding
very close to the lumen- can be burst through high pressure, food endoscope passing
what do we do about varicose bleeding
plastic cap at end of endoscope
stick the cap over the bulge
suction and suck up varic the bleeding bit
bit of string- cutes off blood supply- bleeding point isolated and bleeding stops
other treatment for varicose bleeding
sclerosant
glue
arterial bleeding
arteries in gut can be eroded into
treatment for arterial bleeding
injection therapy
adrenaline
tamponade
vasoconstriction
heater probe - coagulation
clips- ligate
self sealing last about a fortnight then fall off
treating angiodysplasia
argon plasma coagulation
recent work with radio frequency ablateion
treating strictures
dilation
stenting- usually reserved for malignancy
removable stents
complications of a stent
foreign body sensation reflux fever septicaemia fistula formations bleeding perforation pain migration tumour in/overgrowth
tpyes of dilation
balloon
bouginage
treating tumours
polypectomy
endoscopic mucosal removal
polpypectomy
raise polyp on a bed of adrenaline/saline
snare
hot biopsy
endoscopic mucosal resenction
hraise lesion on a bed of adrenaline/saline
loop and conver to polyp
snare
how to remove intraluminal objects
stones
foreign body removal
foreign body removal
snare or basket
overtube
GA with endotracheal tube
low nutrition treatment
PEG insertion
naso-jejunal tube insertion
how to insert PEG
gastroscopy identify insertion site transabdominal passage of wire pull wire out of mouth tie PEG to wire and pull into position fix in place and set up connectors
how to use a naso-jejunal tube
pass tube under direct vision pull out endoscope feed in nasal overtube draw NJ tube into overtube withdrawn through nose fix in place
screening asymptomatic individuals
prevention of colorectal cancer
detect polyps and remove them
early detection of cancer
what disease are screened for by an endoscope
ulcerative colitis
colonic polyps
colorectal cancer
barrettes oesophagus
preparing for endoscope
indication- clear and justifies explanation to patient consent fasting bowel prep moniter bleeding diathesis infection prophylaxis (endocarditis, shunt, immunosuppression)
complications of endoscoope
aspiration cardiac arrest bleeding resp arrest perforation infections
