Endoscope and The GI Tract Flashcards
What are the uses of endoscopes?
Diagnosis
Therapeutics - emergency and elective
Screening
Surveillance
What are the parts of a basic endoscope?
Screen, light source, air/ water, control head, flexible tip
What are the specialized types of endoscope?
Gastroscope Colonoscope Side viewing scope (ERCP) enteroscope (in btw SI) Capsule Endoscopic ultrasound
What are the uses+problems with capsules?
Smooth plastic covering, battery, light and can move through the small intestine and give a very good look.
Bad as the battery could break down and cause ulcers
Uses of EUS scopes
Needle comes out at the side. Press it on the gut wall. Used in oesophageal cancer
What are the techniques used in Endoscopy?
Endoscope controls in the left hand, tip held in the right hand.
What does it help to visually diagnose?
Oesophagitis Gastritis Ulceration Coeliac disease Crohn's disease Ulcertive coelitis Sclerosing Cholangitis
What are the common vascular abnormalities?
Varices
Ectatic blood vessels (extra vessels)
Angiodysplasia
Miscellanous cond. associated with tumours
Tearing of the skin of lower esophagus - Mallory-weiss tears
Diverticulate
Foreign bodies (bezoars, food bolus, razor blades)
Stones
Worms
What are the pros of Early diagnosis of tumours?
Pre- malignant conditions
Easily remove them
Easy to follow up
Screening (less known for barrets oesophagus)
Barrets cancer
Oesophageal mucosa turns to gastric mucosa after years of acid reflux
Old imaging techniques
Used ipdine as a dye, good staining but very sore. Hence not preferred.
INewer imaging techniques
Blue light reflects of the surface, green light reflects further down
Microscopic diagnosis
Biopsy and histology
Brushing and cytology
Aspirates and biopsy
How is biopsy done?
Biopsy forceps come from colonoscope and pinch out a lesion
Therapeutics in endocope
Ability to treat down endoscope- GI bleeding, nerve blocks, resection of early cancer
Bleeding in GI include what?
Variceal bl.
Arterial bl.
Angiodysplasia
Important clinical observations include what?
Haematemesis 500 ml of bleeding
Malena - more than 50p ml of bleeding in the gut
Treatment of variceal bleeding
Life threatening emergency ABC resuscitation Injection sclerotherapy Banding (suck up the layer of BV, put the band around and seal it) Histocryl glue Sclerosant - fibrin used
Treatment of arterial bleeding
Injection therapy (adrenaline: tamponade, vasoconstriction) Heater probe (coagulation) Clips (ligate)
Treatment of angiodysplasia (small BV)
Argon plasma coagulation
Radiofrequency ablation (for teeny tiny ones all over the place)
How to remove tumours?
Polypectomy
Endoscopic mucosal removal/ resection
What is the endoscopic mucosal resection (EMR)?
Put band around, cut and take it out
Special endoscopic submucosal siddection in Japan. What is it?
.
What are the intraluminal objects removed?
Foreign bodies
Stones
How to remove stones?
Sphincteroctomy
Ballon and trawl
Lithotripsy
How to remove foreign bodies?
.
Nutrition aids
PEG insertion
PEJ
Naso- jejunal tibe insertion
What does Naso- jejunal tibe do?
.
What is the imp of screening in asymptomatic indv.?
Prevention of colorectal cancer
Detect polyps and remove them
Early detection of cancer
What is the imp of surveillance ( early detection of complication in indv with risk)?
Ulceratove colitis
Colonic polyps and colorectal cancer
Barret’s oesophagus
Preparation before the procdure
Indication Explanation Consent Fasting .
Complications of the procedure
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How are patients selected?
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