Overview of upper gastrointestinal endoscopy (esophagogastroduodenoscopy)
- Jonathan Cohen, MD
Jonathan Cohen, MD
- Clinical Professor of Medicine
- New York University School of Medicine
- David A Greenwald, MD, FASGE, FACG
David A Greenwald, MD, FASGE, FACG
- Professor of Clinical Medicine
- The Mount Sinai Hospital
Upper gastrointestinal endoscopy (esophagogastroduodenoscopy, EGD) includes visualization of the oropharynx, esophagus, stomach, and proximal duodenum, with real-time assessment and interpretation of the findings encountered. A variety of technical and cognitive aspects must be mastered in order to perform a high-quality examination. The basic technical components of upper endoscopy also serve as the platform upon which many therapeutic interventions are based.
The elements of high-quality performance in endoscopy have been well described and include the following [1,2]:
Prior to the procedure
●Appropriate indications and adherence to guidelines
●Suitable environment with adequate support team
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- Chirica M, Champault A, Dray X, et al. Esophageal perforations. J Visc Surg 2010; 147:e117.
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- PATIENT SELECTION
- - Diagnostic examinations
- - Caustic ingestions
- - Screening/surveillance
- - Planned therapeutic intervention
- Important considerations
- PATIENT PREPARATION
- Management of anticoagulants
- Antibiotic prophylaxis
- Preprocedure testing
- SEDATION ASSESSMENT
- INFORMED CONSENT
- Intubation with the endoscope
- Esophagus and esophagogastric junction
- Pyloric intubation
- DIAGNOSTIC AND THERAPEUTIC MANEUVERS
- Tissue sampling
- PHOTODOCUMENTATION AND REPORTING
- TROUBLESHOOTING COMMON PROBLEMS IN UPPER ENDOSCOPY
- Complications related to sedation
- QUALITY INDICATORS FOR EGD
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS