gastrointestinal endoscopy
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Introduction
A procedure for viewing the interior of the body. For gastrointestinal endoscopy video atlas see DAVE
Laboratory
- none routinely indicated
- testing may be indicated depending upon medical history & physical examination findings
- coagulation studies:
- active bleeding
- known or suspected bleeding disorder
- medication risk (anticoagulation, prolonged antibiotics)
- prolonged biliary obstruction
- history of abnormal bleeding
- history of liver disease
- malabsorption (sprue)
- malnutrition
- acquired coagulopathies (leukemia)
- active bleeding
- Type & cross-match if blood transfusion considered likely
- complete blood coutn (CBC):
- anemia
- risk factors for bleeding
- high risk for adverse events with significant bleeding
- advanced liver disease
- hematologic disorder
- procedure associated with a high risk of bleeding
- chemistries
- significant endocrine, renal, or hepatic dysfunction
- medications that may further impair function
Diagnostic procedures
- electrocardiogram:
- advanced age & comorbid illness
Procedure
Radiology
- chest x-ray
- advanced age,
- significant smoking history
- recent upper respiratory tract infection
- severe or decompensated cardiopulmonary disease
Complications
- excess risk (12/1000) of thromboembolism* within 30 days of procedure# if anticoagulation* is withheld[1]
- complication rates were 1% for EGD & screening colonoscopy and 0.7% for diagnostic colonoscopy
- infection from contaminated endoscopes
- aspiration pneumonia[10]
- colonic perforation[10]
- serous complications associated with older age & longer duration of general anesthesia[10]
* excess risk of stroke in patients anticoagulated for atrial fibrillation
Management
- repeating upper gastrointestinal endoscopy or colonoscopy may detect source of obscure GI bleed[2]
- direct oral anticoagulants should be stopped 24-36 hours prior to procedure in low to intermediate-risk patients
More general terms
More specific terms
- capsule endoscopy
- colonoscopy
- flexible sigmoidoscopy
- ileoscopy
- jejunoscopy
- proctoscopy
- upper gastrointestinal (GI) endoscopy; esophagogastroduodenoscopy (EGD)
Additional terms
References
- ↑ 1.0 1.1 Journal Watch 23(23):183, 2003 Blacker DJ et al, Neurology PMID: https://www.ncbi.nlm.nih.gov/pubmed/14526038
- ↑ 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17 American College of Physicians, Philadelphia 2009, 2012, 2015
- ↑ Leffler DA et al. The incidence and cost of unexpected hospital use after scheduled outpatient endoscopy. Arch Intern Med 2010 Oct 25; 170:1752. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20975024
- ↑ Akerman PA, Agrawal D, Chen W, Cantero D, Avila J, Pangtay J. Spiral enteroscopy: a novel method of enteroscopy by using the Endo-Ease Discovery SB overtube and a pediatric colonoscope. Gastrointest Endosc. 2009 Feb;69(2):327-32 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19100974
- ↑ ASGE Standards of Practice Committee, Sharaf RN, Shergill AK, Odze RD et al Endoscopic mucosal tissue sampling. Gastrointest Endosc. 2013 Aug;78(2):216-24 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23867371 also see corresponding NGC guideline
- ↑ 6.0 6.1 Epstein L et al New Delhi Metallo-beta-Lactamase-Producing Carbapenem-Resistant Escherichia coli Associated With Exposure to Duodenoscopes. JAMA. 2014;312(14):1447-1455. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25291580 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1911326
Rutala WA and Weber DJ Gastrointestinal Endoscopes. A Need to Shift From Disinfection to Sterilization? JAMA. 2014;312(14):1405-1406. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25291575 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1911309 - ↑ Guidelines on the role of endoscopy in patients with chronic pancreatitis. American Society for Gastrointestinal Endocopy (ASGE) http://www.asge.org/nspages/practice/patientcare/sop/index.cfm
- ↑ ASGE Standards of Practice Committee, Anderson MA et al Management of antithrombotic agents for endoscopic procedures. Gastrointest Endosc. 2009 Dec;70(6):1060-70. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19889407
- ↑ Early DS, Lightdale JR, Vargo JJ, et al. Guidelines for sedation and anesthesia in GI endoscopy. Gastrointest Endosc. 2018 Feb;87(2):327-337. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29306520 <Internet> http://www.giejournal.org/article/S0016-5107(17)32111-9/fulltext
- ↑ 10.0 10.1 10.2 10.3 10.4 Lieber SR, Heller BJ, Martin CF, Howard CW, Crockett S. Complications of anesthesia services in gastrointestinal endoscopic procedures. Clin Gastroenterol Hepatol 2019 Oct 14; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31622738 https://www.cghjournal.org/article/S1542-3565(19)31110-3/pdf