Endoscopic Retrograde Cholangiopancreatography (ERCP) (Gastrointest Endosc 2005;62:1-8 & 2003;57:633-38) INDICATIONS: Biliary Diagnosis and extraction of common bile duct stones (if high suspicion) Diagnosis of primary sclerosing cholangitis Investigation, brushing and…

Esophagogastroduodenoscopy (EGD) (Gastrointest Endosc 2002;55:784-93 & 2000;52:831-837) INDICATIONS: Diagnostic: Upper GI symptoms that are persistent or worrisome: dysphagia/odynophagia; abdominal pain; gastric outlet obstruction; chest pain after cardiac evaluation, iron deficient…

Colonoscopy (Gastrointest Endosc 2003;57:441-5) INDICATIONS: Diagnostic: Screening for colon polyps/cancer; including preoperative evaluation of patients with known colon cancer Symptom evaluation: bleeding (occult or gross) or Abnormal X-ray findings (i.e….

Capsule Endoscopy INDICATIONS: Obscure GI bleeding Signs of GI bleeding: Melena, Hematochezia, Iron deficient anemia Abnormal GI X-ray Crohn’s disease Unexplained abdominal pain AdvanCE: Endoscopic device to deliver the capsule…

Balloon Tamponade Minnesota Tube (4 lumen) is current standard for use; Lumens include: Gastric suction Esophageal suction Gastric balloon and pressure monitoring Esophageal balloon and pressure monitoring Sengstaken-Blakemore Tube (3…

Anticoagulation & Antiinflammatory Management for Endoscopy (Gastrointest Endosc 2005;61:189-194) WARFARIN THERAPY HIGH-RISK PATIENTS:Afib associated with valvular diseaseMechanical valve in the mitral positionMechanical valve and prior thromboembolic event LOW-RISK PATIENTS:DVTUncomplicated or…

Potpourri ARGON PLASMA COAGULATION (APC) THERAPY General recommendations for setting (Do not use with pacemaker) Condition Probe (mm) Wattage (W) Gas Flow (L/min) XRT Proctitis 3.2 65 1.5 GAVE 3.2…

Variceal Bleeding (Gastrointest Endosc 2005;62:651-5. NEJM 2001;345:669-81) DEFINITION: Bleeding from varices For Portal Hypertensive Gastropathy (PHG) and Gastric antral vascular ectasia (GAVE), See also GI Bleed- UGIB & LGIB (Chapter…

Upper & Lower GI Bleeding (Gastrointest Endosc 2005;62:656-60 & 2004;60:497-504. Ann Intern Med 2003; 843-857.) DEFINITION: Intraluminal blood loss anywhere from the oropharynx to the anus (i.e. mouth to butt)…

Occult & Obscure Bleeding (Gastroenterol 2000;118:197-200 & 201-21) DEFINITION: Occult: bleeding that is not visible or hidden and is manifested by positive fecal occult blood testing or iron deficiency anemia…