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Oncologist, radiologist

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Endoscopy of the esophagus

Alexey Portnov, medical expert
Last reviewed: 23.11.2021

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Indications for endoscopy of the esophagus

Diagnostic indications for endoscopy of the esophagus: clarification of the localization of the process; visual examination of pathological changes revealed during examination, clarification of their prevalence; control over the effectiveness of treatment (both conservative and surgical).

Therapeutic indications for endoscopy of the esophagus: removal of foreign bodies, small tumors of the stomach or esophagus; sclerotherapy of varicose veins of the esophagus; stop bleeding.

Contraindications to endoscopy of the esophagus

Absolute contraindications to endoscopy of the esophagus: shock, acute disorders of cerebral and coronary circulation, epileptic seizures, asthma attack, atlantoaxial subluxation, esophageal diseases, in which it is impossible to hold an endoscope in the stomach or there is an increased risk of perforation (esophagus burn, scar stricture, ).

Indications and contraindications to endoscopy of the esophagus

Preparation of the patient for endoscopy of the esophagus

Preparation of the patient for endoscopy, may have some features, depending on the nature of the study (planned or emergency), as well as the general condition of the patient. With planned endoscopy, the patient should not take food for at least 4 hours before the study. 3 h before the procedure, the patient is given seduxen (one tablet - 0.005 g) or another tranquilizer. 20-30 minutes prior to the study, premedication with cholinolytic agents (0.5-1 ml of a 0.1% solution of atropine sulfate, methacine or 0.2% solution of platifillin) is performed.

Preparation for endoscopy of the esophagus

Technique of esophagus endoscopy

Endoscopist becomes the left, facing the subject. The head of the patient is slightly thrown back. On the fibro endoscope put on the mouthpiece, the assistant fixes the head of the patient. The endoscopist grasps the fibroendoscope with his right hand and holds it like a pencil. Before insertion into the esophagus of the endoscope, the distal end of it is slightly bent posteriorly, respectively, by the bend of the oropharynx. The patient is offered to make a swallowing movement at the height of a small breath. At this point, the endoscope is carefully advanced into the cavity of the esophagus. When passing from the pharynx to the esophagus, great caution must be exercised. In connection with the reduction of the lower constrictor of the pharynx, the narrowest, perstneglotochnoe narrowing of the esophagus is formed, the so-called mouth of the esophagus according to Killian, 23 mm in diameter and 17 mm in the anteroposterior direction. There is always some resistance, and therefore the instrument should be carried out smoothly, because possibly perforation of the esophagus. To facilitate progress, at the moment of the throat, the apparatus without violence is injected into the esophagus, releasing at that moment a lever that bends the end of the endoscope. In the pharyngeal cavity, the endoscope is inserted strictly along the midline.

How is endoscopy of the esophagus?