Flashcards in Endoscope and the GI tract Deck (34):
What are the parts of a basic endoscope
Screen, Light source, air/ water, control head and flexible tip
What are some specialised types of endoscope and what do they look at?
Gastroscope - Stomach
Colonoscope - Colon
Side viewing ERCP - Some of the organs that come off of the GI tract
Enteroscope - looking at the bit you cant see with the Gastroscope (Small bowel)
Capsule - pill cam
Endoscopic Ultrasound - lumen of the stomach - can scan the organs from inside out
How big are capsule?
What are the risks with capsule?
They contain a battery which must come out
Difficult to swallow
What are the drawbacks of the EUS Scopes
What do patients need before an endoscope
Sedative or anaesthetic
What are endoscopes used for?
Diagnostics - cancer, inflammation and ulcers
Therapeutics - Biopsy abnormalities
Treat things - to stop a bleeding ulcer
Screening - early diagnoses of cancers - Colorectal cancer screening. taking a healthy population to try and pick up pre-malignant cells and cure them
Surveillance - people with an illness that we want to keep an eye on.
What is Barrett's oesophagus
a metaplasia caused by a chemical irritation
cells undergo a metaplastic change to thick, cuboidal cells so that it is more like the stomach, so not as badly effected by acid reflux
What can be diagnosed through visual diagnoses?
What are the two different types of tumours
Malignant and Benign tumours
What are some vascular abornalities
Ectatic blood vessels (GAVE, Dieulafoy)
What miscellaneous conditions that can be diagnosed / treated through endoscope
What are the therapeutics of Endoscopy?
Ability to treat down the endoscope
Resection of early cancer
What are 3 types of bleeding?
Vomit which is full of blood
Stool with blood with a disgusting smell
What is Variceal Bleeding?
A medical emergency
How do we manage a patient with Variceal Bleeding?
Banding (putting on rubber bands from the endoscope)
What is the aim of injecting a sclerosant
To cause intesive inflammation in the blood vessel and stop bleeding
What is one of the drawbacks of using glue?
The scope can end up glued to the surface you are trying to fix. This needs to be changed quickly!
How can we treat arterial bleeding?
Injection therapy (adrenaline: tamponade, vasoconstriction)
Heater probe (coagulation
How can we treat strictures (narrowing)
Dilation (using balloons)
Stenting (usually reserved for malignancy)
Removable stents - can treat perforations with a reduction in long term sequelae. Some are not biodegradable
What are the main types of stents
Plastic (removable - not often used now)
Metal self expanding (permanent)
How does polypectomy work
Raise polup on a bed of adrenaline / saline
What are polypectomy used for
How does endoscopic mucosal resection (EMR) occur?
Raise lesion on a bed of adrenaline / saline
Loop and convert polyp
What can we remove through ERCP
Stones and foreign body
Describe the removal of a stone
Balloon and trawl
How is a foreign body removed?
Snare or basket
GA with endotracheal tube
How does a PEG insertion occur?
Identify insertion site
Transabdominal passage of wire
Pull wire out of mouth
Tie PEG tube to wire and pull into position
Fix in place and set up connectors
What is the purpose of screening>
Prevention of colorectal cancer
Detect polyps and remove them
Early detection of cancer
What are the complications of Endoscopy
Infection (bacterial endocarditis)
What determines whether a patient is for endoscopy
Patients not for endoscopy include:
Contraindications (recent infarct)
Bleeding diathesis (including anticoagulant therapy)
Infection risk (prosthetic valves, shunts, immunosuppression)