Endoscopy, upper

The assignment of a lesion into one of these types is purely morphological and based on the anatomical location of the tumor or the best estimate of its epicenter for those with advanced disease. Classification can be performed easily based on a combination of contrast radiography, upper endoscopy, and CT (38). In a retrospective analysis of 74 patients with gastric cancer, the preoperative classification had a high correlation (95%) to the final classification based on the resected specimen (39). 

Mui L, Teoh AYB, Enders KWN, Lee Y, Au Yeung ACM, Chan Y, Lau, JYW, Chung SCS. Premedication with orally administered midazolam in adults undergoing diagnostic upper endoscopy a double-blind, placebo-controlled randomised trial. Gastrointest Endosc 2005 61(2) 195-200. 

Fiberoptic upper endoscopy (esophagogastroduodenoscopy) detects more than 90% of peptic ulcers and permits direct inspection, biopsy, visualization of superficial erosions, and sites of active bleeding... 

Dyspepsia may or may not be associated with an ulcer, and in itself is of little clinical value when trying to identify subsets of patients who are most likely to have an ulcer. As many as 50% of patients who take NSAIDs report having dyspepsia. " Patients with dyspeptic symptoms may have either uninvestigated (no upper endoscopy) dyspepsia or investigated (underwent upper endoscopy) dyspepsia. If an ulcer is not confirmed in a patient with ulcer-like symptoms at the time of endoscopy, the disorder is referred to as nonulcer dyspepsia. ... 

The diagnosis of HP infection can be made using endoscopic or nonendoscopic tests (Table 33-6). The tests that require upper endoscopy are more expensive, uncomfortable, and require a mucosal biopsy for histology, culture, or detection of urease activity. Recommendations to maximize the diagnostic yield include taking at least three tissue samples from specific areas of the stomach, as patchy distribution of HP infection can lead to false-negative results. Because certain medications may decrease the sensitivity of these tests, antibiotics and bismuth salts should be withheld for 4 weeks and PPIs for 1 to 2 weeks prior to endoscopic testing. 

Hiki, N., H. Kurosaka, Y. Tatsutomi, et al. 2003. Peppermint oil reduces gastric spasm during upper endoscopy A randomized, double-blind, double-dummy controlled trial. Gastrcmtest. Endosc. 57(4) 475-482. 

Table 22.1. The ultrasound meal accommodation test (UMAX) was developed at Haukeland University Hospital on the basis of close interaction between scientific and clinical work in patients with dyspepsia. Before entering the protocol, the patients have been carefully studied with history, physical examination, blood tests, testing for H. pylori and upper endoscopy. In some cases, additional examinations are performed to rule out organic causes of their symptoms. The protocol presented here is the mainstream clinical protocol. In scientific studies, other elements are often added. A 500-ml liquid meal of commercial meat soup (Toro clear meat soup, Rieber Son A/S, Bergen, Norway) containing 1.8 g protein, 0.9 g bovine fat, and 1.1 g carbohydrate (20kcal) is ingested over a period of 4 min. The soup is preheated and then cooled to 37°C to improve imaging quality by reducing the amount of air bubbles. Psychometric evaluation is also performed...

Amoros A, Aparicio JR, Garmendia M, Casellas JA, Martinez J, Jover R. Deep sedation with propofol does not precipitate hepatic encephalopathy during upper endoscopy. Gastrointest Endosc 2009 70 (2) 262-8. 

We had hypothesized that a possible mechanism leading to an attenuated response to an acute fat load of saturated fat might be a temporary retention of triglycerides in the intestinal mucosa during the process of chylomicron formation and release. In order to evaluate that possibility we took small intestinal biopsies via an upper endoscopy 5 h after the beginning of the fat load. 

Upper endoscopy and duodenal biopsy Lipid-laden LLpid laden Lipid-laden Lipid-laden... 

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