Esophagoscopy - Causes, Symptoms and Treatment .MF .
Esophagoscopy - instrumental method of diagnosis of diseases of the esophagus using an endoscope (a probe), administered through the oral cavity.
This survey method allows you to visually inspect the inside of the esophagus wall, to identify pathological changes in the body, as well as carry out the necessary diagnostic or therapeutic manipulation, for example, the material harvested for histological examination, removal of foreign body, stop bleeding, and others.
Sincethat this method is relatively safe and informative, recently holding esophagoscopy widespread, and it can be performed in outpatient settings.
Esophagoscopy is carried out in a planned or emergency basis, and can be performed under local or general anesthesia.As a rule, a survey carried out with the examination of the stomach and duodenum in fibroezofagogastroduodenoskopii (FEGDS), but can be assigned and as a self-diagnosis method.
Indications prvedeniyu esophagoscopy
Indications for diagnostic esophagoscopy:
- abnormalities of the esophagus development,
- achalasia (narrowing of the lower esophageal sphincter at the junction of the esophagus into the stomach and the abnormal enlargement of the esophagus above it),
- inflammatory andulcerative diseases of the esophagus - esophagitis,
- diverticula, and tumors of the esophagus,
- gastroesophageal reflux - the reverse flow of food from the stomach into the esophagus,
- foreign body,
- assessment of damage in the esophagus chemical burns 7-10 days after poisoning corrosive,
- cicatricial stricture (fusion) of the esophagus, for example, due to chemical burns, for the selection of the optimum size of bougie passed - the device used for the expansion of the esophageal lumen,
- biopsy - for further examination under a microscope otschipyvanie a small piece of tissue (cytological and histological examination, such asto clarify the process of malignancy).
Indications for medical esophagoscopy:
- removal of foreign esophageal body,
- the use of sclerosing agents with esophageal varicose veins to reduce the risk of bleeding from the veins,
- hemostasis using electrocautery or overlay clip on the bleeding vessel,
- introduction bougie passed under direct vision during bougienage.
Indications for esophagoscopy using general anesthesia:
- large foreign body of the esophagus,
- suspected wedging a foreign body in the esophagus wall,
- hearing and speech in a patient,
- mental illness,
- early childhoodage,
- cardiovascular disease.
Carrying esophagoscopy is contraindicated in these diseases:
- general grave condition of the patient,
- chemical esophageal burns in the acute period (7-10 days),
- acute infectious diseases,
- acute diseases of internal organs - appendicitis, pancreatitis, intestinalobstruction,
- severe cardiovascular disease - aortic aneurysm, acute myocardial infarction, pulmonary edema, decompensated heart disease, end-stage congestive heart failure,
- neurological diseases - acute stroke, traumatic brain injury, and so on.
In addition, a study can be difficult in patients with severe curvature of the spine in the neck and thoracic spine, and with significant obesity.
Preparation for the study.
Esophagoscopy is carried out strictly on an empty stomach.The last meal should be at least 5-6 hours before the procedure.Due to the fact that in most cases, the study is not limited to inspection of only the esophagus, and includes a further inspection of the stomach, followed by two to three days eliminate annoying food (fat, salt, acute), refrain from alcohol and cigarettes, as well astemporarily stop taking the medication in consultation with your doctor.
Esophagoscopy can be performed in a clinic or in a hospital, in a planned or emergency basis.20-30 minutes prior to the procedure to branch from which the patient is sent for examination, or directly into the endoscopic study, atropine administered subcutaneously to the patient and to achieve better promedol esophageal muscle relaxation, and for sedation.
After explaining to the patient essentially conducted the study and signing the informed consent of the patient in for the procedure, the doctor can begin to conduct esophagoscopy.In the case where the procedure is performed under local anesthesia, the patient can take a sitting position, lying on his back with drooping shoulders and head, or lying on your left side.Basically, the survey is conducted, as in FEGDS lying on his left side.
With dikaina irrigation solution made of the tongue and oropharynx to loss of sensitivity and suppression of the gag reflex.Further, under the supervision of a doctor of esophagoscope administered to the patient in the midline of the oral cavity, and after reaching the tongue, the doctor turns esophagoscope down, carrying it through the larynx, and reaching the entrance to the esophagus.At this point, the patient is invited to make a swallowing motion, after which the endoscope without effort is in the esophagus.Further examination is conducted esophageal mucosa, and if the technical equipment allows the institution may display the endoscopic picture of the monitor is used in the office and then save photos and video on a digital medium.
After inspecting the endoscope is removed, the patient is asked to wait for a doctor to enter into, and then he can go home, if the survey was carried out in a planned way, and found no dangerous condition requiring emergency care, or the patient is hospitalized in a hospital when esophagoscopy carried outon emergency indications, and need to be treated in hospital.
The entire procedure takes less than 20 minutes, causing discomfort in the patient only during the introduction of Esophagoscopy.There are retching, feeling of suffocation and a desire to cough.To study did not bring significant discomfort, the patient should relax, sit or lie down without moving and follow the doctor's team.Over the next few hours may cause coughing and rawness in the sternum.If these symptoms do not disappear within a day or more, you should tell them about the doctor.
of the procedure under general anesthesia is different in that the patient endotracheally introduced inhalation anesthetics, and he falls asleep by the time required for the procedure.Discomfort may arise in the moment of awakening.
The study protocol the patient will see the main characteristics of the esophageal mucosa.The normal mucosa and its pink color with a shiny surface of the fold.The folds becomes greater when it enters the stomach.Also observed in normal esophageal peristalsis, i.e. successive muscle contraction towards the stomach.In the case of pathological changes described by their character (foreign body, bleeding, ulcers, diverticulitis, etc.), location and quantity.
Photography normal esophagus during esophagoscopy
During the esophagoscopy rarely can develop complications such as perforation (receiving through-hole) wall of the esophagus, bleeding, shock, and anaphylactic allergic reactions, acute respiratory failure and cardiac activity.
prevention of morbidity is a complete collection of information on allergic diseases transferred earlier, as well as soft, without much effort in the introduction of Esophagoscopy esophagus lumen to avoid his injury.
therapists Sazykina OJ