GI Bleed/Endoscopy Lecture Powerpoint Flashcards
Enteroscopy
Viewing of the small intestine with an endoscope inserted down the esophagus
Choledocho- meaning
Common bile duct
Indications for Esophageogastroduodenoscopy (EGD) (5)
- unexplained anemia
- GERD
- abdominal pain
- dysphasia
- barret’s esophagus
EGD prep (3)
- NPO after midnight
- no anticoagulation
- optional sedation (propofol)
EGD complications (2)
- bleeding
- perforation
Black eschar lesions at the GE junction indicates
Gastritis, often 2nd to NSAID use
ERCP (Endoscopic retrograde choleopancreatography) indications (2)
- obstructed common bile duct (choledocholithiasis, pancreatic neoplasm, bile duct neoplasm)
- diagnostic and therapeutic
Endoscopic ultrasound indications (4)
- UGI neoplasm (esophagus, stomach, liver, pancreas, duodenum)
- lymph node biopsy and staging
- choledocholithiasis
- small missed cholelithiasis
Colonoscopy indications (5)
- anemia
- rectal bleeding without identifiable cause
- diverticulitis
- alternating diarrhea and constipation
- screening
Colonoscopy prep (5)
- mechanical bowel prep
- clear liquid diet
- NPO after midnight
- no anticoagulation
- optional sedation
Colonoscopy complications (3)
- bleeding
- perforation
- splenic injury
Types of colonic polyps (4)
- hyperplastic (benign)
- serrated (same as hyperplastic but higher risk of becoming cancer)
- inflammatory
- neoplastic (adenomatous)
Sessile polyp vs pedunculated
Sessile is flatter and covers more surface, pedunculated has a stalk protruding out from a base into a large head
Clinical manifestations of adenomatous polyps (4)
- mostly asymptomatic
- hematochezia
- occult blood loss
- diarrhea
How are adenomatous polyps typically detected? (3)
- sigmoidoscopy
- colonoscopy
- CT scan (virtual colonscopy)
What type of adenoma polyp is most likely to be cancerous?
Villous
Dividing area of upper and lower GI
Ligament of trietz
3 manifestations of GI bleed
- hematemesis
- melena (black dark tarry stool)
- hemotochezia (bright red blood)
Initial management of GI bleed (3)
- resuscitation (2 large bore IV, saline, type o neg packed RBC, same ratio of plasma and platelets)
- labs (beware that the H&H will be maintained in acute losses)
- NG tube
Common causes of upper GI bleed (4)
- gastric and duodenal ulcers (most common)
- varices
- mallorey weis tears
- neoplasms
Ulcer bleeding treatment options (3)
- PPI or H2 blockers
- endoscopic hemostasis via injection therapy of 1:10,000 epi
- coagulation via cauterization
- surgery (failed or recurrent cases)
Anterior wall of the duodenum exits to the ___, posterior wall exits to the ___
free abdomen (perforation), pancreas (gastroduodenal artery bleeding, highest risk of rebleeding)
Gastric/duodenal ulcer that has a clean base treatment options (2)
- nothing endoscopically
- PPI treatment
Varices treatment options (4)
- resuscitation
- balloon tamponade
- endoscopic therapy
- surgical therapy