Duodenoscopy (Endoscopy)

1 What is a Duodenoscopy (Endoscopy)?

Upper endoscopy is a procedure to examine the esophagus (swallowing tube), stomach, and duodenum (first portion of small bowel) using a thin, flexible tube through which the lining of the esophagus, stomach, and duodenum can be viewed using a TV monitor.

It is usually performed to evaluate possible problems with the esophagus, stomach or duodenum, and evaluate symptoms such as upper abdominal pain, nausea or vomiting, difficulty in swallowing, intestinal bleeding anemia, etc.

Before the procedure, the patient must inform his/her physician of any medications that is currently taking, any allergies, and all health problems.

The doctor will instruct the patient whether any of the medications that patient is taking should be held or adjusted prior to the endoscopy and instruct the patient to have stomach empty on the day of the procedure.

During the procedure, the patient's throat will be sprayed with a numbing solution and it will probably be given a sedation and pain alleviating medication through the vein.

The patient will lie on the left side and the flexible endoscope (thick as a small finger) will be passed through the mouth into the esophagus, stomach, and duodenum. Most patients will experience only minimal discomfort during the test and many sleep throughout the entire procedure.

After the procedure, the patient can have a mild sore throat, which promptly responds to saline gargles or a feeling of distention from the insufflated air that was used during the procedure but these problems are mild and transient.

Also because of the use of sedation, most facilities mandate that the patient must not drive home after the procedure, handle machinery, or make important decisions for the remainder of the day. The patient will have the test results prior to discharge and the results of biopsies or cytology (if it was performed) usually 72-96 hours after the procedure.

The advantage of upper endoscopy over X-ray is that is more accurate for detecting inflammation or smaller abnormalities such as ulcers or tumors within the reach of the instrument and biopsies (obtain small pieces of tissue) or cytology (obtain some cells with a fine brush) can be performed to determine the nature of the abnormality and whether the abnormality is benign or malignant (cancerous).

Endoscopy is a safe procedure, and the complications are extremely rare when it is performed by a physician with specialized training.

Complications can include localized irritation of the vein where the medication was administered, reaction to the medication or sedatives used, complications from pre-existing heart, lung, or liver disease, bleeding may occur at the site of a biopsy or removal of a polyp (which if it occurs is almost always minor and rarely requires transfusions or surgery).

Major complications such as perforation (punching a hole through the esophagus, stomach, or duodenum) are rare but usually require surgical repair.

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