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INDICATION AND

PREPARATION
OF UPPER GI
ENDOSCOPY
Preceptor :
Dr. Kiki Lukman, dr, SpB-KBD

Presented by :
Deny Budiman, dr
GASTROINTESTINAL ENDOSCOPY

Types of Gastrointestinal Endoscopy

Esophagogastroduodenoscopy (Upper GI
Endoscopy)
Small Bowel Enteroscopy (Jejunoscopy)
Colonoscopy (Lower GI Endoscopy)
Sigmoidoscopy
Endoscopic Retrograde
Cholangiopancreatogram (ERCP)
UPPER GASTROINTESTINAL
ENDOSCOPY

Diagnostic Indications Therapeutic Indications


Heartburn
Control of bleeding
Dysphagia or odynophagia

Hematemesis or melena Dilation of stricture


Dyspepsia or upper abdominal pain
Removal of foreign bodies
Unexplained weight loss or anemia

Evaluation of abnormal Barium meal Removal of polyps


X-ray

Suspected malabsorption

Tumor ablation
UPPER GASTROINTESTINAL
ENDOSCOPY
Contraindications to Upper GI Endoscopy

Uncooperative patient

Hemodynamically unstable patient

Suspected perforation

cervical spine disorders

Soon after a myocardial infarction


PATIENT PREPARATION

Fasted for at least 4 6 hrs more time for


GOO.
Before the study dentures & eye glasses should be removed.
If intervention is anticipated, a recent coagulation profile
&platelet count should be within safe ranges.
Prophylactic antibiotics indicated in
a. Sclerotherapy.
b. Previous endocarditis.
c. Recent vascular prosthesis.
d. For PEG tube placements.
e. Patients with prosthetic heart valves.
Method
Two squirts of lidocaine sprayed into the
pharynx or lidocaine viscus can be used.
CHECK LIST

24 hours before the examination


Confirm indication
Check contraindications
Necessary lab tests ordered? (blood count,
coagulation)
Antibiotic prophylaxis?
Informed consent obtained?
Patient instructed about fasting?
Cardiac pacemaker?
Risk factors? (heart, lung, coagulation, general
health)
IMMEDIATELY BEFORE THE
EXAMINATION

Patient welcomed to the unit, greeted by name


Signed consent form?
Dentures removed?
Defoaming agent administered?
Coagulation tested?
If necessary: peripheral venous access?
(especially with sedation and for interventions)
Equipment check? (air, suction)
Endoscope tip lubricated
Pharyngeal anesthesia (if desired)
Contact with patient: Here we go.
During the examination
Talk to the patient, explain what is
happening.
Keep the patient in a left lateral position.
Observe the patient (sweating,
restlessness, facial expression, gestures,
pain manifestations, breathing, skin
color).
If in doubt: pulse oximetry,
echocardiogram (ECG) monitoring.