Imaging of the gut

Question 1

what is the GI tract function

Answer 1

• Nutrition – mechanical, digestion, absorption
• Storage
• Excretion
• Endocrine/exocrine
• Immunology
• Defence

Question 2

what is the problem with imaging

Answer 2

• Only two orfices
• A long tube
• Not much light
• Many bends

Question 3

what are the different types of endoscopy

Answer 3

• Upper GI endoscopy
• ERCP
• Enteroscopy
• Capsule endoscopy
• Double balloon endoscopy
• Colonoscopy

Question 4

what are the goals of endoscopy

Answer 4

• Diagsnosis
• Tehrpay
• Surveillance
• Screening

Question 5

what is the advantages of endoscopy as oppose to radiology

Answer 5

• Macroscopic real time view
• Obtain histology
• Visualise entire bowel
• Therapeutics

Question 6

what are the disadvantages of endoscopy as oppose to radiology

Answer 6

• Sedation
• Technically demanding
• Complications
• Limited to luminal views

Question 7

how do you increase the diagnostic yield

Answer 7

• Modify the light properties to enhance detection
• Narrow band imaging
• Chromoendoscopy
• Autofluorescence

Question 8

what are common issues with upper GI

Answer 8

• Dysphagia
• Epigastric pain
• Weight loss
• Anaemia
• Diarrhoea
• Surveillance
• Haematemesis/Meleana
• Odynophagia – pain when swallowing

Question 9

what is therapy for upper GI

Answer 9

• Dilation
• Haemostasis
• Stent
• Variceal management
• Gastrostomy insertion
• Botox injection
• Polypectomy

Question 10

what is capsules endoscopy used for

Answer 10

• Anaermia/bleeding
• Diarrhoea
• Abnormal x ray
• Small bowel samples
• Therapy

Question 11

what is the ideal small bowel investigation

Answer 11

• Safe
• Non invasive
• Examines entire SB
• Picks up flat lesions
• Does not require active bleeding
• Cannot take biopsies

Question 12

describe double balloon endoscopy

Answer 12

• Go through the mouth or rectum to reach mid small bowel
• Full therapeutics
• Sedation – under general anaesthetic as it is a long procedure

Question 13

describe ERCP

Answer 13

• Investigation of billary tree
• Abnormal LFT/billary obstruction
• Now therapeutic – stone removal/relileve obstruction, tumour stenting, manometry

Question 14

what are the stages for a colonoscopy

Answer 14

Diagnosis 
-	Rectal bleeding 
-	Altered bowel habit 
-	Abdominal pain 
Surveillance 
Therapy 
-	Polypectomy 
-	EMR
-	Dilatation 
-	Stent insertion