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Esophageal endoscopy
Last reviewed: 05.07.2025
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Indications for esophageal endoscopy
Diagnostic indications for esophageal endoscopy: clarification of the localization of the process; visual examination of pathological changes identified during examination, clarification of their prevalence; monitoring the effectiveness of treatment (both conservative and surgical).
Therapeutic indications for esophageal endoscopy: removal of foreign bodies, small tumors of the stomach or esophagus; sclerotherapy of varicose veins of the esophagus; stopping bleeding.
Contraindications to esophageal endoscopy
Absolute contraindications to esophageal endoscopy: shock, acute cerebrovascular and coronary circulatory disorders, epileptic seizures, asthma attacks, atlantoaxial subluxation, esophageal diseases that make it impossible to pass an endoscope into the stomach or that pose an increased risk of perforation (esophageal burn, cicatricial stricture, etc.).
Indications and contraindications for esophageal endoscopy
Preparing the patient for esophageal endoscopy
Preparation of the patient for endoscopy may have some features depending on the nature of the examination (planned or emergency), as well as the general condition of the patient. For planned endoscopies, the patient should not eat for at least 4 hours before the examination. 3 hours before the procedure, the patient is given seduxen (one tablet - 0.005 g) or another tranquilizer. 20-30 minutes before the examination, premedication with anticholinergic agents is performed (0.5-1 ml of 0.1% solution of atropine sulfate, metacin or 0.2% solution of platifillin).
Preparation for esophageal endoscopy
Esophageal endoscopy technique
The endoscopist stands on the left, facing the patient. The patient's head is slightly tilted back. A mouthpiece is put on the fibroendoscope, the assistant fixes the patient's head. The endoscopist grasps the fibroendoscope with his right hand and holds it like a pencil. Before inserting the endoscope into the esophagus, its distal end is slightly bent backwards in accordance with the curvature of the oropharynx. The patient is asked to swallow at the height of a small inhalation. At this point, the endoscope is carefully advanced into the esophageal cavity. Great care must be taken when passing from the pharynx to the esophagus. Due to the contraction of the lower constrictor of the pharynx, the narrowest, cricopharyngeal narrowing of the esophagus is formed, the so-called mouth of the esophagus according to Killian, measuring 23 mm in diameter and 17 mm in the anteroposterior direction. Some resistance is always felt here, and therefore the instrument should be passed smoothly, since perforation of the esophagus is possible. To facilitate the advancement, at the moment of swallowing the device is gently inserted into the esophagus, releasing at this moment the lever that bends the end of the endoscope. The endoscope is inserted into the pharyngeal cavity strictly along the midline.
How is esophageal endoscopy performed?
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