GastroEndoscopy - Landers Bioscience.pdf

contents

1. Informed Consent ............................................................. 1
Peter A. Plumeri
Introduction ............................................................................................... 1
Principles .................................................................................................... 1
Method ....................................................................................................... 1
Exceptions .................................................................................................. 2
2. Conscious Sedation and Monitoring ................................. 3
Philip E. Jaffe
Introduction ............................................................................................... 3
Indications and Contraindications .............................................................. 4
Equipment and Accessories ......................................................................... 6
Technique ................................................................................................... 8
Outcome .................................................................................................... 9
Complications .......................................................................................... 10
3. Antibiotic Prophylaxis .................................................... 11
Gregory Zuccaro, Jr.
Introduction ............................................................................................. 11
Infection in Areas Remote from the Gastrointestinal Tract ........................ 11
Infection in the Area of Endoscopic Manipulation .................................... 14
Special Cases ............................................................................................. 16
4. Principles of Endoscopic Electrosurgery ......................... 18
Rosalind U. van Stolk
Introduction ............................................................................................. 18
Current Characteristics and Tissue Effect .................................................. 18
Monopolar Electrosurgery ........................................................................ 19
Bipolar Electrosurgery ............................................................................... 20
Non-Contact Electrosurgery (Argon Plasma Coagulation) ........................ 20
5. The Benign Esophagus.................................................... 22
James M. Gordon
Anatomy ................................................................................................... 22
Esophagitis ............................................................................................... 22
6. Malignant Esophagus ...................................................... 38
Steven J. Shields
Introduction ............................................................................................. 38
Incidence/Epidemiology ........................................................................... 38
Etiology/Risk Factors ................................................................................ 39
Clinical Presentation ................................................................................. 39
Laboratory Evaluation ............................................................................... 40
Diagnostic Evaluation ............................................................................... 40
Staging of Esophageal Tumors ................................................................... 41
Treatment of Esophageal Cancer ............................................................... 42
Survival ..................................................................................................... 46
7. Esophageal Manometry................................................... 48
Brian Jacobson, Nathan Feldman and Francis A. Farraye
Introduction ............................................................................................. 48
Relevant Anatomy .................................................................................... 48
Indications and Contraindications ............................................................ 49
Equipment and Accessories ....................................................................... 50
Technique ................................................................................................. 50
Outcomes ................................................................................................. 52
Complications .......................................................................................... 55
8. Twenty-Four Hour pH Testing ........................................ 58
Brian Jacobson, Nathan Feldman and Francis A. Farraye
Introduction ............................................................................................. 58
Relevant Anatomy .................................................................................... 58
Indications ................................................................................................ 58
Equipment and Accessories ....................................................................... 59
Technique ................................................................................................. 60
Outcomes ................................................................................................. 63
Complications .......................................................................................... 65
9. Gastrointestinal Foreign Bodies ...................................... 67
Patrick G. Quinn
Epidemiology ............................................................................................ 67
Presentation .............................................................................................. 67
History ..................................................................................................... 67
Physical Exam ........................................................................................... 67
Initial Radiographic Evaluation ................................................................. 67
Indications for Removal ............................................................................ 68
Options for Removal, Nonendoscopic ...................................................... 69
Options for Removal, Endoscopic ............................................................. 70
Options if Unable to Remove Foreign Body at Endoscopy ........................ 73
10. Endoscopic Therapy for Nonvariceal Acute
Upper GI Bleeding .......................................................... 75
Peder J. Pedersen and David J. Bjorkman
Introduction ............................................................................................. 75
Anatomy ................................................................................................... 75
Evaluation of Patient with UGIB .............................................................. 75
Indications/Contraindications for Endoscopy in UGIB ............................ 77
Endoscopy Equipment .............................................................................. 77
Endoscopic Findings ................................................................................. 78
Rebleeding Rates ....................................................................................... 78
Endoscopic Therapy and Management of UGIB ...................................... 78
Complications .......................................................................................... 80
11. Endoscopic Management of Lower GI Bleeding ............. 82
Sammy Saab and Rome Jutabha
Introduction ............................................................................................. 82
Indications for Colonoscopy During Acute Lower
Gastrointestinal Hemorrhage .................................................................. 82
Contraindications ..................................................................................... 82
Patient Preparation ................................................................................... 82
Relevant Anatomy .................................................................................... 83
Equipment ................................................................................................ 83
Accessories for Hemostasis ........................................................................ 83
Technique ................................................................................................. 84
Outcome .................................................................................................. 84
Complications .......................................................................................... 85
12. Endoscopic Management of Variceal Bleeding ................ 87
John S. Goff
Introduction ............................................................................................. 87
Relevant Anatomy .................................................................................... 87
Indications for Endoscopic Therapy .......................................................... 88
Contraindication to Endoscopic Therapy of Bleeding Varices ................... 88
Equipment ................................................................................................ 88
Technique ................................................................................................. 89
Outcome of Endoscopic Therapy for Bleeding Varices .............................. 91
Complication of Endoscopic Therapy for Bleeding Varices ....................... 91
13. Lasers in Endoscopy........................................................ 93
Mark H. Mellow
Diseases Treated by Endoscopic Laser Therapy .......................................... 95
14. Endoscopy of the Pregnant Patient ............................... 103
Laurence S. Bailen and Lori B. Olans
Introduction ........................................................................................... 103
Indications .............................................................................................. 103
EGD2..................................................................................................... 103
ERCP2 ................................................................................................... 104
Technique ............................................................................................... 104
Medication Safety ................................................................................... 104
Preparation ............................................................................................. 104
Drugs Used as Premedications and During Endoscopy ........................... 105
Monitoring ............................................................................................. 106
Results and Outcomes of Endoscopy During Pregnancy ......................... 106
Conclusion .............................................................................................
15. Percutaneous Endoscopic Gastrostomy
and Percutaneous Endoscopic Jejunostomy .................. 110
Richard C. K. Wong and Jeffrey L. Ponsky
Introduction ........................................................................................... 110
Indications .............................................................................................. 110
Contraindications ................................................................................... 110
Technique ............................................................................................... 110
Feeding and Local Care ........................................................................... 112
Percutaneous Endoscopic Gastrostomy Tube Replacement ...................... 113
Complications ........................................................................................ 114
Percutaneous Endoscopic Jejunostomy .................................................... 117
Ethical Considerations ............................................................................ 117
16. Small Bowel Endoscopy ................................................ 118
Jeffery S. Cooley and David R. Cave
Introduction ........................................................................................... 118
Relevant Anatomy .................................................................................. 118
Indication and Contraindication ............................................................. 118
Equipment, Endoscopes, Devices and Accessories ................................... 119
Technique ............................................................................................... 121
Outcome ................................................................................................ 123
Complications ........................................................................................ 123
Summary ................................................................................................ 124
17. Flexible Sigmoidoscopy................................................. 125
Richard C.K. Wong and Jacques Van Dam
Introduction ........................................................................................... 125
Relevant Anatomy .................................................................................. 125
Indications .............................................................................................. 126
Contraindications ................................................................................... 126
Endoscope .............................................................................................. 126
Preparing the Patient ............................................................................... 126
Technique ............................................................................................... 128
18. Colonoscopy ................................................................. 131
Douglas K. Rex
Introduction ........................................................................................... 131
Practical Colonoscopic (Endoscopic) Anatomy ....................................... 131
Indications .............................................................................................. 131
Contraindications ................................................................................... 133
Equipment .............................................................................................. 134
Accessories .............................................................................................. 135
Complications ........................................................................................ 138
Technique ............................................................................................... 141
Findings ...................................................................................