Thursday, 6 March 2014

For your information... OGD and dilatation

Oesophago-gastroduodenoscopy is a safe procedure that allows direct visualisation of the upper part of the gastrointestinal tract up to the duodenum.

Indications:
Diagnostic

  • Investigation for anaemia
  • Upper GI bleeding
  • Persistent Dyspepsia
  • Persistent vomiting
  • Dysphagia
  • Odynophagia
Surveillance
  • Surveillance of already diagnosed Barrett's oesophagus
  • Previous gastric/duodenal ulcers
Therapeutic
  • Oesophageal varices
    • Banding
    • Sclerotherapy
    • Epinephrine injections into actively bleeding lesions
    • Insertion of Sengstaken-Blackmore's tube
  • Polyps
  • Removal of FBs
  • Oesophageal stenosis
    • Dilatation
    • Stenting
  • Insertion of PEG tube
  • ERCP

Safety
Most common complication is Sorethroat
Complication rate is 1 in 1000
  • Aspiration
  • Bleeding
  • Perforation
Risk of dilatation
  • Review of 1862 endoscopic dilatations using Savary-Guillard technique showed complication rate of 0.18% for benign strictures and 4.58% for malignant aetiologies (Piotet E, Eur Arch Otorhinolaryngol.  2008 Mar)
  • Certain strictures refractory to treatment and require multiple dilatations
    • E.g. caustic, post-surgical, post radiotherapy strictures.

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