Endoscopy is a nonsurgical procedure used to inspect a person's digestive tract. It can be used to look at the inside of the esophagus, stomach, first portion of intestines known as duodenum, biliary tree and colon. As a result of inspecting the inside of the above mentioned structures biopsies and/or brushings can be taken to aid in diagnosis. Additionally, there are therapeutic maneuvers that may be performed at the time of initial endoscopy for certain conditions.
Esophagogastroduodenoscopy (EGD) - also known as an upper scope or upper endoscopy. This is done in many instances for upper GI symptoms/conditions including esophagitis, reflux disease, hiatal hernia, peptic ulcer disease, obstruction, gastritis, upper GI bleeding, and cancers of the esophagus, stomach or duodenum to name a few. The use of EGD is helpful in the diagnosis of the above mentioned conditions. Many times, at the time of the procedure biopsies may be taken in order to help with diagnosis. Additionally, this procedure can be therapeutic in some instances. For example, bleeding from ulcers or newly created anastamoses (surgically made connections between two organs) can be controlled. Also, should there be a pathologic or surgical stricture of an organ the EGD can be helpful in dilating it. In addition to these maneuvers, the EGD is used when placing a percutaneous gastrostomy tube, also known as a PEG tube. This is used for feeding purposes in many different conditions.
Endoscopic Retrograde Cholangiopancreatography (ERCP) - This procedure requires a general anesthetic and is used to investigate and treat conditions of the bile ducts. It combines the use of endoscopy with the use of fluoroscopy. The first part of the procedure involves using the endoscope to enter into the stomach and duodenum. The portion of the bile duct entering into the intestines is identified endoscopically. Once this is done the portion of the bile duct entering the intestines, known as the sphincter of Oddi, is instrumented to allow for fluoroscopic inspection of the bile duct and pancreatic duct. This methodology allows the endoscopist to identify stones, inflammatory stricutures, leaks or cancer within the bile duct. Should he/she encounter these biopsies/brushings may be taken, stones may be extracted and stents can be placed across leaks or strictures. Additionally, the sphincter can also be made bigger to allow for easier passage of bile and stones should that be required. Therefore, this procedure has diagnostic and therapeutic roles.
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