[Ambulant gastroscopy. Practical arrangement and procedure of gastroscopy with biospy and brush cytology in a group of partially gastrectomized patients].
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Adult↗
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[Ambulatory gastroscopy. Significance of ambulatory gastroscopy as compared with radiographic gastrointestinal passage].
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Ambulatory Care↗
Out-patient gastroscopy risks.
Complications in out-patient gastroscopy were evaluated retrospectively in 995 examinations performed in 625 patients. At the examination seven complications were registered in the gastroscopy record. Two complications: perforation of the stomach and cardiac arrhythmia, required hospitalisation. None of the complications was lethal. Inquiries to the referring general practitioners revealed 5 cases where the gastroscopy had led to consultations because of minor complaints after the examination. Considering all complaints as complications the frequency of complications in out-patient gastroscopy was 1.2%.
Adolescent↗
Open access gastroscopy: too much to swallow?
OBJECTIVES: To ascertain the proportion of endoscopic examinations with normal findings in patients referred for gastroscopy through hospital medical staff or directly by their general practitioner and to assess the likely effect of targeting endoscopy in older patients. DESIGN: Retrospective audit of the gastroscopy practice of one consultant from 1986 to 1988 from information recorded on a standard form completed at the time of the examination, which contained details of patients, their endoscopic findings, and mode of referral (open access or clinic). SETTING: One district general hospital. PATIENTS: 1545 Consecutive patients from primary catchment area attending for their first gastroscopy; 454 were referred through the outpatient clinic or by hospital colleagues (clinic group) and 1091 were accepted for endoscopy solely on their general practitioner's clinical diagnosis (open access group). RESULTS: Similar numbers (about 40%) of examinations with normal findings were performed in each group, although in patients aged over 40 the proportion with normal findings was significantly higher in the clinic group (p less than 0.03). Endoscopic evidence of gastro-oesophageal reflux disease, peptic ulceration, and gastroduodenal inflammation was equally common in each group; upper gastrointestinal malignancy, however, was significantly more common in patients referred through hospital doctors (5%, 23/454 v 2%, 22/1091 respectively; p less than 0.005) (although many of these patients had already been extensively investigated). IMPLICATIONS: Open access gastroscopy does not increase the number of unnecessary examinations and should become more widely available. Targeting this service to patients aged over 40 would reduce the number of requests but increase the diagnostic yield.
Adolescent↗
[Gastroscopy -- a routine procedure in the investigation of diseases of the stomach (author's transl)].
After a short review of the development of endoscopic investigations, the technique of gastroscopy is described and the indications for this procedure are pointed out. This procedure is of equal importance as radio-diagnostic measures in the routine investigation of stomach diseases and is of particular value when used as an emergency procedure and in the follow-up of patients after gastric operations. It also offers great advantages in the diagnosis of stomach tumours since biopsy material can be obtained from the lesion. Stomach haemorrhage due to gastric erosion, oesophagitis and the Mallory-Weiss syndrome are best diagnosed by gastroscopy. There are practically no contraindications to gastroscopy. The only precluding factor being an uncooperative patient. It is not contraindicated in patients with oesophageal varices or deformity of the spinal column. Complications are very rare. In the case of emergency gastrocscopy, shock must be counteracted and the blood pressure normalized before the investigation can be performed.
Emergencies↗
[Complaints after gastroscopy and their cause (author's transl)].
The various complaints after gastroscopy and the acceptability of the procedures are verified by a questionnaire in 300 consecutively examined patients with or without gastric lesions. The extent of psychic lability, neurosis and extraversion was determined by the Maudsley Personality Inventory test of Eysenck. The time necessary for the passage of the instrument (swallowing time) and the time taken by gastroscopy were registered on each patient. More than half of the patients complained of sore throat lasting more than 1 day. Less than a quarter had abdominal dyspepsia. The intensity of the sore throat was correlated with the swallowing time but not with the extent of neurosis or gastroscopy time. 98% of the patients consented to a control examination. The necessity of a gastroscope with less diameter and a non mucosal damaging top is stressed.
Adult↗
Gastroscopy.
Gastroscopy has become a safe and reliable procedure following the development of modern fibreoptic instruments which have replaced the semi-flexible gastroscope. Indications for gastroscopy may be diagnostic (to elucidate the nature of definite or indefinite radiological abnormalities, in persistent X-ray negative dyspepsia, post gastric surgery symptoms and upper gastrointestinal bleeding) or therapeutic (including polypectomy, electrocoagulation of bleeding points, papillotomy and removal of retained stones and the use of a laser beam to control bleeding). In can be done as an outpatient procedure with a low incidence of complications in experienced hands, but should be performed only in a properly equipped area with resuscitation facilities. Gastroscopy should form part of the routine investigation of patients with upper gastrointestinal problems where the appropriate indications are present.
Fiber Optic Technology↗
The value of gastroscopy in clinical diagnosis: a computer-assisted study.
The additional information obtained by gastroscopy in patients already examined by upper gastrointestinal roentgenography was assessed. For this purpose, a data sheet for computer analysis was filled in at the time of gastroscopy and again at patient dismissal. Overall, gastroscopy resulted in an altered diagnosis in 18 percent of 1, 368 examinations, and in another 7 percent of cases there were findings of possible clinical significance. Gastroscopic findings differed significantly from x-ray findings in 7 to 35 percent of cases, depending on the indication for the procedure.
Computers↗
[Gastroscopy after gastric operations (author's transl)].
Gastroscopy after surgery of the stomach gives exact information about functional and morphological alterations. The aim of gastroscopy is to detect complications of the early postoperative period as well as of the later phase. Early diagnosis of gastric carcinoma after partial gastrectomy for benign lesions is only possible by routine gastroscopy.
Gastroscopy↗
[Examination using the gastro-camera and gastroscopy--confrontation and complementation].
Both the gastro-camera and gastroscopy are methods of examination dating back to the last century. Since 1955 examination with the gastro-camera has gained major importance in Japan. Not until the efficient gastroscopic instruments based on fiber optics and with extremely flexible points as well as advance view optical systems were developed large-scale, introduction esophageal gastro-bulboscopy in hospitals and in offices of specialists became possible. In our view the replacement of the gastro-camera method of diagnosis as a basic examination by gastroscopy is not justified. The gastro-camera is highly efficient and easily applied if centers for early diagnosis of gastric tumor cooperate with the examining physicans; their own experience with the gastro-camera is a premise for this arrangement. The principal task of endoscopic diagnosis is the determination as to therapy, namely whether surgery or a conservative method should be applied: this is particularly true in the case of early carcinoma stages where a 90% 5-year survival chance prevails. For various reasons gastro-camera examination should be assigned a more prominent role. Gastroscopy and histological examination represent further steps in diagnosing malignant processes. It is not possible to preclude the possiblity of a malignant tumor by means of gastroscopic biopsy.
Biopsy↗
[Gastroscopy in Austria the results of a questionnaire study (author's transl)].
By means of a questionnaire we have gathered information about gastroscopy in Austria. This inquiry has enabled us to compare the techniques used and the results obtained in the diagnosis of gastric cancer. The final aim of the investigation was to obtain guidelines for the wider application of gastroscopy for the early diagnosis of gastric cancer. The level of response by Austrian endoscopists to the inquiry was high at 72.7%. The results demonstrate a considerable increase in the use of gastroscopy in Austria over the past few years. However, some of the provinces hate fallen behind others. The available equipment is not fully used and reasons for this are discussed. A close correlation is shown to exist between the number of gastric biopsies carried out and the incidence of early gastric cancer. It is further shown that the use of cytological brushing improves the results. Only one third of endoscopists, however, use this method.
Austria↗
[Consequences of routine gastroscopy before cholecystectomy].
In a retrospective study of 610 patients the role of routine gastroscopy prior to cholecystectomy was investigated. The results demonstrated that only in a low incidence (11% of patients gastroscopied) relevant findings are present. However, most of these patients had a typical history. Therefore, despite risks, routine preoperative endoscopy prior to cholecystectomy should be performed only in patients with a history of upper abdominal pain or discomfort.
Adolescent↗
Continuous electrocardiographic monitoring with Holter electrocardiocorder throughout all stages of gastroscopy.
Continuous electrocardiographic recording on magnetic tape with a Holter electrocardiocorder was performed during gastroscopy on 55 consecutive patients. ECG recording was begun before premedication and was terminated 1 hr after the withdrawal of the gastroscope. The ECG changes during the different stages of the procedure were separately analyzed: 38.18% of patients had E.C.G. changes--sinus tachycardia (20%), ST-T changes (23.6%), ventricular and atrial premature beats (20.0% and 7.27%, respectively). atrial premature beats with aberrant conduction (3.6%), and coronary sinus rhythm (1.8%). All changes disappeared spontaneously after the procedure. Although relatively safe, gastroscopy requires careful consideration of the risks, especially in severe cardiac patients.
Adult↗
Death following fiberoptic gastroscopy caused by pheochromocytoma.
A 45-year-old woman was admitted to hospital for investigation of weight loss, sciatica and excess sweating. On examination, whe was found to have a tachycardia and the stigmata of von Recklinghausen's disease. Her investigations included a barium meal and gastroscopy. Following the gastroscopy, she developed ventricular tachycardia and died. An autopsy revealed a pheochromocytoma of the left adrenal gland.
Adrenal Gland Neoplasms↗
Gastroscopy in surgical practice.
We reviewed the records of 100 consecutive patients who had gastroscopy. All endoscopic work was done by our four-man surgical group. Roentgenographic and endoscopic diagnoses are compared with reference to degree of accuracy. The expanded uses of gastroscopy in surgical practice are illustrated and a plea is made for increased involvement of surgeons in the rapidly expanding field of endoscopy.
Adolescent↗
Respiratory failure following gastroscopy.
A 61-year-old, bronchitic male developed respiratory failure due to a pneumoperitoneum following gastroscopy. The management of this case and the possible complications following gastroscopy are described and discussed.
Cough↗
Changes in plasma enzyme concentrations following intramuscular injections and gastroscopy.
The effects of intramuscular injections on plasma creatine kinase (CK), aspartate amino-transferase, lactate dehydrogenase, and hydroxybutyrate dehydrogenase concentrations were examined in 19 patients given intramuscular premedication for gastroscopy, and 18 patients given other intramuscular injections. Only CK concentrations showed significant increases which were as high as four times the upper limit of normal, and affected a maximum of 51% of patients at 12 hours after the first injection. Elevated CK concentrations persisted for up to 72 hours, and followed injections of diazepam, various antibiotics, and the combination of a narcotic analgesic with atropine. Gastroscopy did not appear to increase plasma enzyme concentrations in six patients who were given intravenous premedication. The significance of these findings to the diagnosis of myocardial infarction is discussed.
Adult↗
Complications of Fiberoptic Endoscopy. I. Esophagoscopy and Gastroscopy.
Flexible fiberoptic endoscopes are being used increasingly for direct visualization and biopsy of lesions in the upper gastrointestinal tract. Contrary to earlier expectations, however, the incidence of complications has not diminished despite the technical advantages of modern flexible instruments over semirigid endoscopes; indeed, the mortality of fibergastroscopic perforation has almost quadrupled compared to standard gastroscopy. The authors cite their experience with the spectrum of complications associated with fiberoptic esophagoscopy and gastroscopy. Radiological recognition and evaluation of these iatrogenic incidents is of paramount importance.
Adult↗