Principles of Endoscopy Flashcards
What is diagnostic endoscopy
minimally invasive (non surgical) technique for diagnosis and treatment of a variety of conditions
a technique that allows the vet to look within an organ or body cavity to evaluate an area of interest
a means of obtaining diagnostic samples from a specific region of the body. Examples include…
- airway fluid sampling/bronchoalveolar lavage
- tissue biopsies (GI tract, nasal mucosa)
What is therapeutic endoscopy
a means of enabling a therapeutic procedure. Examples include…
- removal of a foreign body from oesophagus, airway or stomach
either remove or push into stomach so it can be removed
- management of an oesophageal stricture
- placement of a gastric feeding tube
When to leak test endoscopy equipment
Before cleaning- make sure no damage has been done meaning cleaning fluid would get into scope
4 examples of endoscopy instruments
biopsy forceps
foreign body retrieval forceps or baskets
cytology brushes
broncho alveolar lavage catheters
What must be ruled out before you do endoscopy due to oesophageal disease
Megaoesophagus (by radiography)- or other oesophageal motility issues
4 small animal GI indications for endoscopy
Suspicion of oesophageal disease
Acute vomiting due to a gastric foreign body
Suspected severe gastric ulceration
Chronic GI signs….for example….
- vomiting/haematemesis
- chronic diarrhoea (SI or LI?)
- Melaena- upper GI bleed
- weight loss
! Make sure GI tract is empty!
What is malaena
Black faeces due to small intestinal bleeding
How many sites to take biopsies from by endoscopy
As many as you can- always scope duodenum/SI as well as stomach
Abnormal Gi tract may look grossly normal
while animal is anaesthetised take as many as you can
When would you preform endoscopy for respiratory signs in small animals
Chronic cough where foreign body suspected or airway fluid sampling might be helpful (cytology/culture)
Top tips for bronchoscopy:
Always perform diagnostic imaging first (radiography or CT)
Consider the possible risks as well as benefits especially in cats/small dogs where the airway is small!- danger of plugging parts of the airway- need to maintain good oxygenation
“First do no harm”
When would you preform endoscopy for urinary signs in small animals
Lower urinary tract signs eg dysuria, haematuria, incontinence
Top tips for urethroscopy/cystoscopy:
Always perform urinalysis and diagnostic imaging first (radiography +/- ultrasound +/- contrast studies)
Consider whether the anatomy is best suited to rigid scope (females) or flexible scope (male)
5 examples of when to use endoscopy in horses
Suspected upper airway/laryngeal obstruction
Investigation of abnormal respiratory noise
Suspected lung disease
Gastric ulceration
Urinary tract disease
What to do if everything looks normal in endoscopy
Collect samples anyway!- usually multiple biopsies from multiple sites for GI disease eg stomach, duodenum, colon, ileum
3 things that can go wrong with endoscopy
Aspiration: cuffed endotracheal tube
Damage to scope: mouth gag
GI perforation: never force the scope, always use plenty of lubrication
What is a flexible endoscope
Long flexible device with a distal “bendable” end controlled from a handpiece
2 types of flexible endoscope
Fibreoptic endoscopes:
pixelated images and/or damage to optic fibres reduces image quality
Video endoscopes:
superior image quality and reduced repair costs
