The Endoscope and the GI tract Flashcards
Components of a basic endoscope?
Light source, air/water
Control head
Flexible tip
Specialised types of endoscopes?
Gastroscope Colonoscope Side viewing (ERCP) scope Enteroscope Capsule Endoscopic ultrasound
Visual diagnosis?
Oesophagitis Gastritis Ulceration Coeliac disease Ulcerative colitis Sclerosing cholangitis
What vascular abnormalities can be found with an endoscope?
Varices
Ectatic blood vessels
Angiodysplasia - small vascular malformation of the gut; a common cause of otherwise unexplained GI bleeding and anemia
Miscellaneous conditions?
Mallory-Weiss tears Diverticulae Foreign bodies (Bezoars, food bolus, razor blades) Stones Worms
Therapeutic uses of the endoscope?
Ability to treat down the endoscope
GI bleeding
Nerve blocks
Resection fo early cancer
Treatment of variceal bleeding?
Injection sclerotherapy (ethanolamine)
Banding
Histocryl glue
Treatment of arterial bleeding?
Injection therapy (adrenaline: tamponade, vasoconstriction) Heater probe (coagulation) Clips (ligate)
Treatment of angiodysplasia?
Argon plasma coagulation
Radio-frequency ablation
Treatment of strictures?
Dilatation using a balloon or bouginage
Stenting: usually reserved for malignancy
Removable stents can be used to treat perforations, etc
Types of stents?
Plastic (removable)
Metal self-expanding (permanent)
Complications of stenting?
Foreign body sensation Reflux Fever Septicaemia Fistula formation Bleeding Perforation Pain Migration Tumour in/overgrowth
Treatment for tumours?
Polypectomy (usually for colonic polyp) - raise polyp on a bed of adrenaline/saline, snare it and then use a hot biopsy
Endoscopic mucosal resection - raise lesion on a bed of adrenaline/saline, loop and convert to a polyp and then snare
Methods of foreign body removal?
Snare or basket
Overtube
GA with endotracheal tube
Methods of delivering nutrition?
PEG insertion
PEJ
Naso-jejunal tube insertion
