Upper gastrointestinal endoscopy

Indications includes dyspepsia, but in general is not a desired procedure because of its low yield unless alarm symptoms of an underlying malignancy are present.

Complication rate of less than 1 per 5000 cases.

Complication rates 0.13-0.24%,perforation rates 0.03-0.1% and mortality rates of .005-.03%.

Risk of esophageal dilation associated perforation 0.15%.

The gastroesophageal junction is evident on endoscopy at the top of the gastric folds, where the squamocolumnar junction is seen at the transition from light pink squamous mucosa of the esophagus to the red columnar mucosa of stomach.

When propofol is used for endoscopy procedures reduces procedural recovery times, improves procedure throughput and increases the efficiency of endoscopy units.

Routine biopsies of normal-appearing esophagus or gastroesophageal junction are not recommended.

Routine biopsies of the normal-appearing gastric body and antrum for detecting Helicobacter pylori infection are recommended if H. pylori status is unknown.

Biopsy utilizes five-biopsy Sydney System with all specimens placed in a single container while obtaining automatic special staining of the specimens is suggested against.

Important benefit to detecting and eradicating H. pylori infection in patients with dyspepsia, both with respect to symptomatic relief and gastric cancer risk reduction.

Routine biopsies of the normal-appearing duodenum for detecting celiac disease in patients without signs or symptoms are not recommended.

Routine biopsies of the normal-appearing duodenum are suggested for detecting graft-vs-host disease in immunocompromised patients with post-allogeneic tissue transplantation or opportunistic infections.

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