By Joseph Leung MD, Simon Lo MD
Dr. Joseph Leung and Dr. Simon Lo have designed this exact reference, which bargains specialist suggestion, personal tastes, and critiques on tricky medical questions and events generally encountered in endoscopy. the original Q&A structure offers easy accessibility to present details concerning healing endoscopy with the simplicity of a talk among colleagues. Illustrative photographs, diagrams, and references are integrated to augment the knowledge of endoscopy.
Curbside session in Endoscopy: forty nine medical Questions provides info uncomplicated sufficient for citizens whereas additionally incorporating professional suggestion that even high-volume clinicians will have fun with. Gastroenterologists, fellows and citizens in education, surgical attendings, and surgical citizens will all enjoy the ordinary and informal layout and the professional recommendation contained within.
Some of the questions which are answered:
• You have been referred to as by means of the ER medical professional concerning a lady who tried to devote suicide by means of consuming a few "toilet cleansing solution". there have been seen burns round the mouth and tongue. What might you do next?
• Is there a job for steel stents in benign bile duct strictures? whilst should still i exploit plastic stents during this setting?
• whilst Is EUS useful for a Newly clinically determined melanoma of the Esophagus,Stomach, Colon, or Pancreas?
• i've got trouble controlling the course of a biliary papillotomy. Any tips to enhance the implications ?
• What Are the positive aspects that Differentiate a Submucosal Bulge from a real Mass on pill Endoscopy? What am i able to Do to verify a Submucosal Mass?
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Extra resources for Curbside Consultation in Endoscopy: 49 Clinical Questions
Coins removed with rat-tooth forceps. Figure 3-7. Fish bones removed with rat-tooth forceps. Figure 3-8. Dental prostheses removed with snare. What Are the Essential Tools for Removing Esophagogastric Foreign Bodies? 19 References 1. Eisen GM, Baron TH, Dominitz JA, et al. Guideline for the management of ingested foreign bodies. Gastrointest Endosc. 2002;55:802-806. 2. Hachimi-Idrissi S, Corne L, Vandenplas Y. Management of ingested foreign bodies in childhood: our experience and review of the literature.
A nasogastric tube insertion for enteral feeding may be used if oral feeds are not tolerated. Feeding jejunostomy is recommended if the patient continues to have severe odynophagia or absolute dysphagia. The role of early dilatation in acute corrosive injuries is controversial. There are no data to suggest that early dilatation prevents esophageal stricture. On the contrary, early dilatation increases the risk of complications and may accelerate fibrosis and stricture formation. The dilatation of an esophageal stricture is initiated after 4 to 6 weeks of corrosive injury.
If the presence or degree of dysplasia is indeterminate, the opinion of an expert GI pathologist is recommended. If there is evidence of acute inflammation due to gastroesophageal acid reflux, repeat biopsy should be performed after 8 weeks of effective acid-suppression therapy. Surveillance in patients with confirmed low-grade dysplasia (LGD) is recommended and a followup esophagogastroduodenoscopy (EGD) at 6 months should be performed, with biopsies in the area of dysplasia. If LGD is confirmed, management includes surveillance at 12 months (4-quadrant biopsies every 1 to 2 cm) and yearly thereafter as long as dysplasia persists.