GI Imaging Flashcards
Upper GI Endoscopy:
What can you see with a normal endoscopy?
What can be done during this for diagnostic purposes?
What can be done to see the distal duodenum and proximal jejunum?
Allows visualisation of oesophagus, stomach and proximal duodenum
Biopsy
Push enteroscopy with longer scope
Upper GI Endoscopy:
Indications - 4
Acute upper GI blessing
Suspected upper GI malignancy
Any persistent upper GI symptoms which don’t respond to treatment
Coeliac diagnosis
Upper GI Endoscopy:
What would increase your suspicion of an upper GI malignancy?
Iron deficiency Anaemia Dysphagia Dyspepsia with onset age >55 yrs Weight loss Epigastric mass
Upper GI Endoscopy:
What should be stopped for procedures with high bleeding risk?
Does any thing need to stopped for biopsy?
What about NSAID’s and aspirin?
Anticoagulants
Antiplatelets
No
Can be continued
Upper GI Endoscopy:
How many weeks before the procedure should a PPI be stopped?
How long should the patient fast before procedure?
What about fluids?
How can discomfort be reduced as much as possible? - 2
2 wks
6 hrs
stop 2 hrs before
Topical throat anaesthesia +/- IV sedation
Upper GI Endoscopy:
Complications - 3
Perforation
Bleeding
Respiratory depression from sedation
Lower GI endoscopy:
What therapeutic procedures can be done?
Polypectomy - polyps - precancerous
Stenting - for blockage
Decompression - twisting of bowel
Lower GI endoscopy:
2 types and where they reach
Sigmoidoscopy - splenic flexure - detects 75% of colorectal cancers
Colonoscopy - terminal ileum
Lower GI endoscopy:
Indications - 3
Suspected colorectal cancer
Suspected IBD
Bowel obstruction
Lower GI endoscopy:
What would suggest there is colorectal cancer present?
What test can be done to detect blood in stool?
PR bleeding
Altered bowel habit in elderly
Iron deficiency anaemia
Lesion seen on imaging
Positive FOB - Positive faecal occult blood test
Lower GI endoscopy:
In what situation should it not be done?
Perforation present
Increased risk of perforation due to diverticulitis
Lower GI endoscopy:
What type of diet should patient be on from day before procedure?
How many hours before should you fast from food?
What about fluids?
What else must be done to enable a clear view?
Low residue diet
6 hrs
2 hrs
Clear bowel of faeces - usually using enema
Lower GI endoscopy:
What should be stopped for procedures with high bleeding risk?
Does any thing need to stopped for biopsy?
What about NSAID’s and aspirin?
Anticoagulants
Antiplatelets
No
Can be continued
Lower GI endoscopy:
What drug can be given to sedate them?
What else needs to be given?
Midazolam
Analgesia
What 2 situations are AXR indicated?
Bowel obstruction
Foreign body