the endoscope and the GI tract Flashcards
what are the 4 parts of the basic endoscope?
screen
light source, air water
control head
flexible tip
name 6 types of specialised endoscope
gastroscope (stomach) colonoscope (colon) side viewing (ERCP) scope (liver/biliary tree) enteroscope (push, double balloon) Capsule Endoscopic ultrasound
list 4 uses of endoscopes
diagnosis
therapy (emergency and elective)
screening
surveillance
what visual disgnoses can be made via endoscopy?
oesophagitis gastritis ulceration coeliac disease crohns disease ulcerative colitis sclerosing cholangitis
what is contained within the endoscope?
camera
tube to suck up blood etc
light
how do capsules work?
swallowed has battery (so must pass through, cant get stuck or will cause damage), light and camera which produces video of GI tract as it passes through
what does EUS scope do?
press up against wall
produces image of organs etc via altrasound
can take samples via needle
describe the endoscopy technique
endoscope tip inserted
direction of the endoscope operated with left hand by endoscope controls
what type of vascular abnormalities can be discovered by endoscopy?
varices
ectatic blood vessels (GAVE, dieulafoy)
angiodysplasia
name some miscellaneous conditions that can be picked up on by endoscopy
Mallory-Weiss tears diverticulae foreign bodies (bezoars, food, razor blades etc) stones worms
what are the benefits of early diagnosis?
can pick up pre-malignant conditions
can remove tissue in minimally invasive way
easy to follow up
screening
what is barrets cancer?
.
small initial lesion can be removed if caught early
what is lugals iodine used for?
squirted onto oesophagus, makes abnormal mucosa more obvious
chromoendoscopy
what is narrow band imaging?
uses different lights to illuminate deeper tissue
how are diagnoses made via microscopy?
biopsy and histology
brushings and cytology
rarely, aspirates and biopsies for microbiology
what is a therapeutic endoscopy?
endoscopy with the ability to treat down the endoscope
what 3 types of bleeding can occur in the GI tract?
variceal bleeding
arterial bleeding
angiodysplasia
what clinical observations indicate GI bleeding?
haematemesis (vomiting dark, bloody, thick sunstance)
Malaena (dark brown, bloddy, thick, feaces)
How is variceal bleeding treated?
medical emergency Banding injection fibrinogen histocryl glue ABC, resuscitate
how is arterial bleeding treated?
injection therapy (adrenaline: tamponade, vasoconstriction) heater probe (coagulation) Clips (ligate)
what is angiodysplasia and how is it treated?
small vascular malformation of the gut
treated with:
- argon plasma coagulation
radio frequency ablation
how are strictures treated?
stenting (usually in malignancy)
what are the 2 types of stent and where are they used?
used in oesophagus, biliary tree, colon
Plastic (removable)
Metal self expanding (permanent)
what are the possible complications of a stent?
reflux fever septicaemia fistulae foreign body sensation bleeding
name 2 methods of dilatation
balloon
bouginage
.
.
via what 2 methods can early stage tumours be removed?
polypectomy
endoscopic mucosal removal
what is a polypectomy?
removal of polyp before it turns cancerous
1)raise polyp on a bed of adrenaline/saline
2)snare
3)hot biopsy
Usually for colonic polyps
what is an endoscopic mucosal removal?
removal of early stage cancer/precancerous growths
1) raise lesion on bed of adrenaline/saline
2) loop and convert to poly
3) snare
give 2 examples of intraluminal objects that would need to be removed
stones (ERCP)
foreign bodies
.via what 3 methods can stones be removed?
.sphincterotomy
balloon and trawl
lithotripsy
name 3 methods of foreign body removal
snare or basket
overtube
GA with endotracheal tube
how are endoscopes used in nutrition?
PEG insertion
PEJ
naso-jejunal tube insertion
what is PEG insertion?
gastroscopy transabdominal passage of wire pull wire out of mouth Tie PEG tube to wire and pull into position Fix in place and set up connectors
What is anaso-jejunal tube?
pass tube under direct vision pull out endoscope feed in nasal overtube draw NJ tube into overtube withdraw through nose fix in place
what are the aims of screening?
prevention of colorectal cancer
detect polyps and remove them
early detection of cancer
what things is surveillance used for?
ulcerative colitis (IBD)
colonic polyps and colorectal cancer
Barrets oesophagus
how are patients selected for endoscopy?
indications
contraindications (recent infarct)
bleeding diathesis (eg. anticoagulants)
infection risk (prosthetic valves)
how must a patient be prepared for endoscopy?
clear indication explanation to patient consent fasting bowel preparation (emptying) monitor bleeding diathesis infection prophylaxis
what complications can arise from endoscopy?
resp arrest aspiration cardiac arrest bleeding perforation infection
