What organs can be checked with an endoscopy?
Endoscopic procedures for liver diagnosis
Endoscopic procedures are an established and reliable method of investigating the body’s internal organs. An endoscope is a long, flexible fibre optic tube with a tiny camera and a light on the end.
ERCP is an endoscopic procedure that is valuable in both examining your biliary and pancreatic structures. It can identify problems with the biliary tree, cystic duct obstruction, gallstones, narrowings and tumours. As a treatment, ERCP can use interventions to drain pus as well as dislodge, break down and remove gallstones.
You should get instructions from the hospital where your ERCP has been scheduled. These will provide you with guidelines on any preparations you need to make before the procedure, such as how long beforehand you’ll need
to stop eating and drinking, and whether it means any possible changes in your medication.
At the beginning of the procedure, the doctor will spray the back of your throat with a local anaesthetic to make it feel numb. Sometimes a local anaesthetic lozenge is used, or you will be given a sedative injection through the drip
(venflon) in your hand or arm. This will make you drowsy so that it lessens the discomfort of having a tube passed into your gullet. You will be positioned on your side to follow the curvature of your gut.
The doctor will ask you to swallow the first section of the endoscope. After this the doctor will push it further down your gullet into your stomach and duodenum. The doctor will look at images on a TV monitor which come from
the endoscope’s camera which is filming the procedure.
Air is also passed into the tube into your gut to make it easier to see the lining of the gut. This may make you feel bloated. The endoscope is designed with an attachment down which small instruments and tubes can be passed.
Endoscopic procedures
A small tissue sample (biopsy) from the lining of the gut can be taken to check for abnormal tissue or cells. The sample is used for two types of test, histology and pathology (see page 22).
If the X-rays show a gallstone obstructing the bile duct, the doctor can widen the duct by making a cut to let the stone into the duodenum. This is called a sphincterotomy.
If there is a narrowing in the bile duct the doctor can place a stent to open it up and keep it from collapsing. The stent can remain in place to help to drain away bile into the duodenum.
The endoscope is gently pulled out when the procedure is completed. It takes around 30 minutes to one hour, depending on what is done.
Your aftercare will depend on the findings of the ERCP. You might be booked in for an overnight stay if you have received a stent or had gallstones removed. You should not drive for 24 hours after receiving a sedative.
Ask a friend or relative to drive you home from hospital. Also make sure that someone can stay with you for the first 24 hours after discharge from hospital. The hospital will also provide you with information when you are discharged
that will help with any problems that might arise after an ERCP procedure.
Endoscopic techniques are also used to treat bleeding varices (small, protruding veins in the stomach and gullet). The most common technique is variceal banding (see below). Occasionally injection scelotherapy may be
performed, which is when a saline solution is injected into a vein, causing the walls of the injected vein to collapse and seal shut. Blood is directed through other, unaffected veins, and eventually the collapsed vein is reabsorbed into
the body.
In this section and useful links
- Back to liver disease tests, diagnosis and screening
- Liver conditions
- Support for you
Gastroscopy
A gastroscopy is a test that looks at the inside of your food pipe (oesophagus), stomach and the first part of your small intestine (small bowel).
A doctor or specialist nurse (endoscopist) does the test. They use a long flexible tube which has a tiny camera and light at the end. This tube is called a gastroscope or endoscope.
You may also hear this test called an endoscopy or oesophago gastric duodenoscopy (OGD).
Why do I need a gastroscopy?
You might have a gastroscopy to find out the cause of symptoms such as:
- abnormal bleeding
- indigestion or heartburn that doesn’t go away with medicines or keeps coming back
- low levels of iron (iron deficiency anaemia)
- difficulty or painful swallowing
- losing weight without trying to
- you keep feeling or being sick
- having blood in your sick
- blood in your poo or passing black poo
If you have Barrett’s oesophagus you’ll have regular gastroscopies. This is to check for any changes to cells in the lining of your food pipe.
During the test your endoscopist takes samples (biopsies) of any abnormal looking areas. They send the samples to the laboratory to be looked at under a microscope.
- Find out more about Barretts’s oesophagus
Preparing for your gastroscopy
You might have blood tests beforehand to check your blood levels and how well your blood clots.
Tell your doctor if you’re taking medicines that changes how your blood clots. This inlcudes:
- warfarin or heparin
- aspirin
- clopidogrel
- apixaban or rivaroxaban
- ticagrelor
Your doctor will tell you if you need to stop taking these or any other medicines for a while before your gastroscopy.
You can’t eat for 6 hours before the test, but you might be able to drink sips of water up to 2 hours beforehand. Your doctor or nurse gives you written instructions about this before your appointment.
Talk to your doctor if not eating could be a problem for you. For example, if you have diabetes.
What happens?
Most people have a gastroscopy as an outpatient, which means you go home the same day. The test usually takes up to about 15 minutes. But expect to be in the hospital for several hours.
First you meet your nurse who asks you about your medical history and any allergies you might have. They may also take measurements such as your blood pressure and heart rate.
Your nurse or endoscopist explains the procedure and asks you to sign a consent form. This is a good time to ask any questions you might have.
Some endoscopy units may ask you to change into a hospital gown. But you can usually have the test in your own clothes.
Usually you’re awake when you have the test, but you can choose to have medicine to relax you. These make you drowsy (sedation).
If you have any false teeth or wear glasses you need to remove them for the test. Your nurse puts a plastic guard in your mouth to protect your teeth from the gastroscope.
This animation shows how you have an endoscopy, it lasts for 1 minute 19 seconds.
Endoscopy
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An example of an endoscopic procedure
An endoscopy is a procedure used in medicine to look inside the body. [1] The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ.
There are many types of endoscopies. Depending on the site in the body and type of procedure, an endoscopy may be performed by either a doctor or a surgeon. A patient may be fully conscious or anaesthetised during the procedure. Most often, the term endoscopy is used to refer to an examination of the upper part of the gastrointestinal tract, known as an esophagogastroduodenoscopy. [2]
For nonmedical use, similar instruments are called borescopes.
History [ edit ]
Adolf Kussmaul was fascinated by sword swallowers who would insert a sword down their throat without gagging. This drew inspiration to insert a camera, the next problem to solve was how to insert a source of light, as they were still relying on candles and oil lamps. [3]
The term endoscope was first used on February 7, 1855, by engineer-optician Charles Chevalier, in reference to the uréthroscope of Désormeaux, who himself began using the former term a month later. [4] The self-illuminated endoscope was developed at Glasgow Royal Infirmary in Scotland (one of the first hospitals to have mains electricity) in 1894/5 by Dr John Macintyre as part of his specialization in the investigation of the larynx. [5] [ failed verification ]
Medical uses [ edit ]
Operation part of the endoscope
Insertion tip of an endoscope
Endoscopy may be used to investigate symptoms in the digestive system including nausea, vomiting, abdominal pain, difficulty swallowing, and gastrointestinal bleeding. [6] It is also used in diagnosis, most commonly by performing a biopsy to check for conditions such as anemia, bleeding, inflammation, and cancers of the digestive system. [6] The procedure may also be used for treatment such as cauterization of a bleeding vessel, widening a narrow esophagus, clipping off a polyp or removing a foreign object. [6]
Specialty professional organizations that specialize in digestive problems advise that many patients with Barrett’s esophagus receive endoscopies too frequently. [7] Such societies recommend that patients with Barrett’s esophagus and no cancer symptoms after two biopsies receive biopsies as indicated and no more often than the recommended rate. [8] [9]
Applications [ edit ]
An anoscope, a proctoscope, and a rectoscope with approximate lengths
Endoscopy surgery
Health care providers can use endoscopy to review any of the following body parts:
- The gastrointestinal tract (GI tract):
- endoscopic retrograde cholangiopancreatography (ERCP), duodenoscope-assisted cholangiopancreatoscopy, intraoperative cholangioscopy
- The nose (rhinoscopy)
- The upper respiratory tract (laryngoscopy)
- The lower respiratory tract (bronchoscopy)
- The cervix (colposcopy)
- The uterus (hysteroscopy)
- The fallopian tubes (falloposcopy)
- The abdominal or pelvic cavity (laparoscopy)
- The interior of a joint (arthroscopy)
- Organs of the chest (thoracoscopy and mediastinoscopy)
- During pregnancy
- The amnion (amnioscopy)
- The fetus (fetoscopy)
- Combines laryngoscopy, esophagoscopy, and bronchoscopy
- Hand surgery, such as endoscopic carpal tunnel release
- Knee surgery, such as anterior cruciate ligament reconstruction
- Epidural space (Epiduroscopy)
- Bursae (Bursectomy)
- Maxillary sinus surgery
- Apicoectomy
An endoscopy is a simple procedure that allows a doctor to look inside human bodies using an instrument called an endoscope. A cutting tool can be attached to the end of the endoscope, and the apparatus can then be used to perform minor procedures such as tissue biopsies, banding of oesophageal varices or removal of polyps.
Application in other fields [ edit ]
- For non-medical use, such as internal inspection of complex technical systems, borescopes are used. These are similar to endoscopes.
- The planning and architectural community use architectural endoscopy for pre-visualization of scale models of proposed buildings and cities
- Endoscopes are also a tool helpful in the examination of improvised explosive devices by bomb disposal personnel.
- Law enforcement uses endoscopes for conducting surveillance via tight spaces.
Risks [ edit ]
The main risks are infection, over-sedation, perforation, or a tear of the stomach or esophagus lining and bleeding. [10] Although perforation generally requires surgery, certain cases may be treated with antibiotics and intravenous fluids. Bleeding may occur at the site of a biopsy or polyp removal. Such typically minor bleeding may simply stop on its own or be controlled by cauterisation. Seldom does surgery become necessary. Perforation and bleeding are rare during gastroscopy. Other minor risks include drug reactions and complications related to other diseases the patient may have. Consequently, patients should inform their doctor of all allergic tendencies and medical problems. Occasionally, the site of the sedative injection may become inflamed and tender for a short time. This is usually not serious and warm compresses for a few days are usually helpful. While any of these complications may possibly occur, each of them occurs quite infrequently. A doctor can further discuss risks with the patient with regard to the particular need for gastroscopy.
After the endoscopy [ edit ]
After the procedure, the patient will be observed and monitored by a qualified individual in the endoscopy room, or a recovery area, until a significant portion of the medication has worn off. Occasionally the patient is left with a mild sore throat, which may respond to saline gargles, or chamomile tea. It may last for weeks or not happen at all. The patient may have a feeling of distention from the insufflated air that was used during the procedure. Both problems are mild and fleeting. When fully recovered, the patient will be instructed when to resume their usual diet (probably within a few hours) and will be allowed to be taken home. Where sedation has been used, most facilities mandate that the patient be taken home by another person and that they not drive or handle machinery for the remainder of the day. Patients who have had an endoscopy without sedation are able to leave unassisted.
See also [ edit ]
References [ edit ]
- ^ «Endoscopy». British Medical Association Complete Family Health Encyclopedia. Dorling Kindersley Limited. 1990.
- ^
- «Endoscopy». Cancer Research UK . Retrieved 5 November 2015 .
- ^
- «The pioneers of endoscopy and the sword swallowers».
- ^
- Janssen, Diederik F (2021-05-17). «Who named and built the Désormeaux endoscope? The case of unacknowledged opticians Charles and Arthur Chevalier». Journal of Medical Biography. 29 (3): 176–179. doi:10.1177/09677720211018975. ISSN0967-7720. PMID33998906. S2CID234747817.
- ^
- «The Scottish Society of the History of Medicine» (PDF) .
- ^ abc
- Staff (2012). «Upper endoscopy». Mayo Clinic . Retrieved 24 September 2012 .
- ^
- American Gastroenterological Association, «Five Things Physicians and Patients Should Question» (PDF) , Choosing Wisely: an initiative of the ABIM Foundation, American Gastroenterological Association, archived from the original (PDF) on August 9, 2012 , retrieved August 17, 2012
- ^
- Spechler SJ, Sharma P, Souza RF, Inadomi JM, Shaheen NJ (March 2011). «American Gastroenterological Association medical position statement on the management of Barrett’s esophagus». Gastroenterology. 140 (3): 1084–91. doi:10.1053/j.gastro.2011.01.030. PMID21376940.
- ^
- Wang KK, Sampliner RE (March 2008). «Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett’s esophagus». The American Journal of Gastroenterology. 103 (3): 788–97. doi:10.1111/j.1572-0241.2008.01835.x. PMID18341497. S2CID8443847.
- ^
- «Endoscopy». NHS Choices. NHS Gov.UK . Retrieved April 20, 2017 .
Esophageal Bougie Dilator
Endoscopy is used for many procedures:
