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Esophagogastroduodenoscopy
Last reviewed: 23.04.2024
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The goals of esophagogastroduodenoscopy are the detection of lesions of the mucous membranes of the esophagus, stomach and duodenum in acute and chronic infectious diseases, other diseases or complications. Implementation of medical measures. Evaluation of the effectiveness of treatment.
Indications for esophagogastroduodenoscopy
Planned EHDS is shown:
- with suspected involvement of the esophagus, stomach, duodenum;
- to assess the effectiveness of treatment;
- for carrying out of medical manipulations;
- for correcting the therapy.
Emergency EHDS is shown:
- with bleeding from the upper gastrointestinal tract;
- with suspicion of perforation of the esophagus, stomach and duodenum;
- if there is a suspicion of a foreign body in the upper gastrointestinal tract;
- with stenoses of the esophagus for carrying out the probe into the stomach for feeding purposes;
- for differential diagnosis of stomach diseases and acute surgical diseases.
Contraindications of esophagogastroduodenoscopy
There are no absolute contraindications to EGDS.
Diseases of the esophagus, in which it is impossible to hold an endoscope in the stomach or there is an increased risk of perforation (esophagus burn, scar stricture, aortic aneurysm, etc.). When using modern endoscopes, the risk is smaller, but it is not excluded. Relative contraindication is the general severe condition of the patient in connection with the underlying or concomitant disease, which poses a direct threat to the life of the patient.
Preparation for the study of esophagogastroduodenoscopy
The evening before dinner a light dinner (excluding products that promote gas generation - milk, fruits, vegetables).
In the absence of stool for 3 days or more on the eve of the study, it is necessary to make a cleansing enema.
The study is performed strictly on an empty stomach.
The patient should explain the principle of this technique and the stages of the study; should find out if the patient is not allergic to the drugs that are supposed to be anesthetized.
The procedure for the study of esophagogastroduodenoscopy
EGDS are performed according to the generally accepted methodology.
Equipment - fibrogastroscope (gastrofibroscope, gastroscope, fibroscope) - endoscope with flexible fiber optics.
Evaluation of result
EGDS makes it possible to carry out a differential diagnosis with jaundice of non-infectious etiology, oncological processes in the upper gastrointestinal tract, clarify the nature of lesions in HIV infection (candidiasis of the esophagus, lymphoma, Kaposi's sarcoma), opisthorchiasis, fascioliasis, Helicobacteriosis and other infectious and parasitic diseases, identify varicose veins with cirrhosis of the viral etiology.
Complications
The use of the fibrogastroscope ensures practical safety of the study. However, if the method of investigation is violated, the walls of the esophagus, stomach and duodenum and even their perforation can be damaged. In these cases, urgent surgical intervention is necessary.
The most common complications of a general nature, caused by intolerance to drugs used for premedication and anesthesia. Sometimes bleeding occurs after a mucosal biopsy or after a polypectomy, removal of a foreign body that does not require surgical intervention.
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