ENDOSCOPY Flashcards
What percentage of people have throat spray (local anaesthetic) during the procedure?
Not more than 60%
What is the sedative used for this procedure?
Medazalan (Benzodiazepine)
What is the adjunct to medazalan during this procedure?
Fentanyl (opiate)
What is the chance of perforating the patients GI?
Less than 0.01
What are the indications for a OGD?
Melena Haemotemesis Epigastric pain Dysphasia Adinaphasia (pain swallowing) Reflux Weight loss Vomiting Iron deficient anaemia
What do you biopsy to diagnose coeliac disease?
Duodenum
What could you stent during OGD?
Oesophagus
Pyloric sphincter
Duodenum
What can we do for GI bleeds?
Clip bleeding vessels
Corterise
Inject adrenaline
How far can you go with a colonoscopy?
Terminal ileum
What is bowel preparation?
Taking purgatives such as pikalax which flush out the bowel.
Would all patients undergoing endoscopy have sedation?
No but the vast majority would.
How long does it take to get to the caecum?
5 mins for a simple patient but can be more like 30-40 mins in a trickier patient.
When do you look for the pathology? On the way in or the way out?
The way out. This should take 6 mins minimum.
What makes this procedure painful?
Inflating the bowel with air or CO2.
What is a sigmoidoscopy?
Endoscopy up to half way up descending colon. No colon flush is required.
What side of the colon is thinner and therefore more likely to be perforated?
The right side (ascending colon) is a lot thinner. Can be only 2-3 mm.
What are the indications for colonoscopy?
Bright red stool Persistent constipation Diarrhoea Tenesmus Screening for colorectal cancer Removal of polyps
What are the treatment possibilities with this procedure?
Haemostasis
Stent
Polypectomy
What does OGD stand for?
Oesophageal Gastro Duodenoscopy
What does ERCP stand for?
Endoscopic Retrograde Cholangio-Pancreatography
What does an ERCP assess?
The biliary tree
Does an ERCP put a camera into the ampullae?
No. It inserts a wire into the ampullae, which injects X-ray contrast and take an X-ray to see the biliary tree.
Can ERCP be used therapeutically?
ERCP can treat certain problems found during the test. If an abnormal growth is seen, an instrument can be inserted through the endoscope to obtain a sample of the tissue for further testing (biopsy). If a gallstone is present in the common bile duct, the doctor can sometimes remove the stone with instruments inserted through the endoscope. A narrowed bile duct can be opened by inserting a small wire-mesh or plastic tube (called a stent) through the endoscope and into the duct.
What does EUS stand for?
Endoscopic Ultrasound
What might you use an EUS for?
Biopsy of lesions close to but outside the GI tract and pancreas.
