how do you report an egd with eus on a patient who has had previous gastric bypass surgery

by Sydney Wisozk 5 min read

Endoscopy reporting standards - PMC

13 hours ago  · A study conducted by Spodik et al has shown that providing an endoscopy report to patients after an endoscopic examination diminishes postprocedure anxiety, improves recollection of findings and recommendations, and increases the level of compliance to the given recommendations and follow-up plan . Thus, when a patient is discharged, an ... >> Go To The Portal


Why would a gastroenterologist order an EGD?

EGD is used to evaluate a number of digestive disorders. It is a popular diagnostic option because patients generally tolerate it well and it causes minimal discomfort. Your gastroenterologist may use EGD to evaluate: Abdominal pain. Heartburn. Persistent nausea or vomiting.

What does an EGD not show?

An EGD does not visualize the upper GI system from the outside and does not provide reliable information about the lungs, liver, spleen, or other nearby organs.

How is an EGD performed?

An EGD utilizes an endoscope that is advanced from the mouth down to the GI tract. The endoscope is thin and flexible, and it has a camera and microsurgical tools attached.

What are the risks of EGD procedure?

In general, an EGD is a safe procedure. There’s a very slight risk that the endoscope will cause a small hole in your esophagus, stomach, or small intestine. If a biopsy is performed, there’s also a small risk of prolonged bleeding from the site where the tissue was taken.

Can you have an endoscopy after gastric bypass?

When performing an endoscopy after gastric bypass surgery, care should be taken to carefully enter the gastric pouch under continuous direct vision. The pouch is typically small and extends just 5 to 7 cm from the Z-line. A strictured anastomosis can be pin size and not accommodate the endoscope.

Is it safe to have an endoscopy after gastric sleeve?

Spectrum of endoscopic findings and therapy in patients with upper gastrointestinal symptoms after laparoscopic bariatric surgery. Obes Surg 2006; 16:1232. Lee JK, Van Dam J, Morton JM, et al. Endoscopy is accurate, safe, and effective in the assessment and management of complications following gastric bypass surgery.

Can I have an endoscopy with a gastric band?

The treatment of reflux in gastric band patients should be carefully considered. Endoscopy should not be used without consideration of alternative strategies. Reflux in gastric band patients is often related to the device.

Is an EUS the same as an EGD?

Conclusion. The combination of EGD with EUS is equivalent to EGD plus TUS for diagnosing a potential etiology of upper abdominal pain. EUS is superior to TUS for detecting chronic pancreatitis. EGD combined with EUS should be considered in the first-line diagnostic evaluation of patients with upper abdominal pain.

How do you know if you have a stricture after gastric bypass?

Your healthcare provider will assess your symptoms and give you a physical exam. You may have a test called an upper GI series. This uses X-rays and contrast dye that you swallow. This can show if there is a stricture.

Can gastric bypass patients have a colonoscopy?

Bariatric surgery patients can still receive diagnostic procedures such as colonoscopy when required and need not worry that their reduced stomach size will prevent them from such. The most important part of a bariatric surgery patient's colonoscopy is preparation and communication between patient and doctor.

Is an endoscopy a surgical procedure?

Summary. Endoscopy is a medical procedure that allows a doctor to inspect and observe the inside of the body without performing major surgery. An endoscope is a long, usually flexible tube with a lens at one end and a video camera at the other.

Why do they do an endoscopy before bariatric surgery?

In conclusion, according to the higher percentage of a large range of disorders in upper-GI tract in obese patients, we suggest that routine preoperative endoscopy prior in bariatric surgery patients may help in the discovery of GI pathologies that may affect not only the surgery procedure but also the bariatric follow ...

What is an EGD procedure?

EGD is an endoscopic procedure that allows your doctor to examine your esophagus, stomach and duodenum (part of your small intestine). EGD is an outpatient procedure, meaning you can go home that same day. It takes approximately 30 to 60 minutes to perform.

What is a EGD with EUS?

Endoscopy (EGD) with. Endoscopic Ultrasound (EUS) prep instructions. You have been scheduled to have an upper gastrointestinal endoscopy (EGD) with endoscopic ultrasound (EUS). This procedure helps detect and/or treat problems affecting your esophagus, stomach, liver, gallbladder, bile duct, lymph nodes, and pancreas.

What is the difference between an endoscopy and an endoscopic ultrasound?

Endoscopy refers to the procedure of inserting a long flexible tube via the mouth or the rectum to visualize the digestive tract (for further information, please visit the Colonoscopy and Flexible Sigmoidoscopy articles), whereas ultrasound uses high-frequency sound waves to produce images of the organs and structures ...

What is the difference between ERCP and EUS?

The main difference between the two is that endoscopic ultrasound utilizes high-frequency sound waves to generate a virtual image and ERCP procedure uses a video camera. These two techniques are commonly used for examining organs like the liver, gall bladder, and pancreas.

What are some examples of EUS referrals?

Examples of reasons for referral for an EUS include: Dilated pancreatic duct. Dilated bile duct. Swollen/inflamed pancreas. Suspected stones in the pancreas duct or bile duct. Suspected blockage of the pancreas or bile duct. History of recurrent episodes of acute pancreatitis.

What is an EUS test?

EUS allows for very detailed imaging and analysis of the pancreas. As such, it is an excellent test for evaluating many different kinds of diseases that can occur in the pancreas. Examples of such pancreatic conditions for which EUS can be extremely useful are: Pancreatic masses and tumors. Pancreatic cysts.

What is the procedure called for pancreatic cancer?

For many patients who have, or who are suspected of having pancreatic disease, their doctor may recommend that they undergo a type of procedure called an endoscopic ultrasound, or more often known as EUS. An EUS is a type of endoscopic examination. It involves the insertion of a thin tube into the mouth and down into the stomach and ...

Why is EUS important?

This is important for some patients who are having a work-up for abdominal pain as it allows for a complete examination of the upper GI system. The biggest advantage of EUS is that, unlike with CT or MRCP, pancreatic biopsies can be safely and easily obtained at the time of the exam.

What is an EUS?

An EUS is a type of endoscopic examination. It involves the insertion of a thin tube into the mouth and down into the stomach and the first part of the small intestine. At the tip of the tube is a small ultrasound probe that emits sound waves. These sound waves bounce off of the surrounding structures, such as the stomach, small intestine, ...

What is the needle used for in a pancreatic cyst?

In these cases, the needle is used to sample the fluid which is contained in the cyst. This fluid can be sent for biochemical, cytologic, and molecular analysis in order to help characterize the type of pancreatic cyst you have. In certain circumstances, larger biopsy samples of the pancreas may be required.

Why do you do FNA?

Because this is done at the time of the EUS, the physician is able to direct the needle to the exact location of interest all while watching the needle with the EUS. FNA is most commonly performed to evaluate masses or tumors of the pancreas, in order to determine if cancer is present. Another very common reason for performing an FNA is in ...

What causes abnormal EGD results?

The following may cause abnormal EGD results: Celiac disease results in damage to your intestinal lining and prevents it from absorbing nutrients. Esophageal rings are an abnormal growth of tissue that occurs where your esophagus joins your stomach. Esophageal varices are swollen veins within the lining of your esophagus.

What is the esophagus?

The esophagus is the muscular tube that connects your throat to your stomach and the duodenum, which is the upper part of your small intestine. An endoscope is a small camera on a tube. An EGD test involves passing an endoscope down your throat and along the length of your esophagus.

What causes a portion of the stomach to bulge through the opening in your diaphragm?

A hiatal hernia is a disorder that causes a portion of your stomach to bulge through the opening in your diaphragm. Esophagitis, gastritis, and duodenitis are inflammatory conditions of the lining of your esophagus, stomach, and upper small intestine, respectively.

Where is the endoscope inserted?

Once the sedatives have taken effect, the endoscope is inserted into your esophagus and passed down into your stomach and the upper part of your small intestine. Air is then passed through the endoscope so that your doctor can clearly see the lining of your esophagus. During the examination, the doctor might take small tissue samples using ...

How long before EGD can you eat?

You won’t be able to eat anything for 6 to 12 hours before the test. People who wear dentures will be asked to remove them for the test.

Why do you need an EGD test?

Your doctor may recommend an EGD test if you have certain symptoms, including: severe, chronic heartburn. vomiting blood. black or tarry stools. regurgitating food. pain in your upper abdomen. unexplained anemia. persistent nausea or vomiting.

Why do you have to wear a mouth guard after an endoscope?

You’ll have to wear a mouth guard to prevent damage to your teeth or the camera.

What is endoscopic ultrasound (EUS)?

Endoscopy — use of a scope to look at the inside lining of the gastrointestinal (GI) tract.

Preparing for an EUS

There are important steps you must take to safely get ready for your endoscopic ultrasound (EUS). These are general instructions. Be sure to follow any instructions given to you by your doctor.

During an EUS

Your doctor will tell you more specifically what you can expect during the test. Some things may include:

After your EUS

Your doctor will tell you more specifically what you can expect after the test. Some things may include:

Safety of EUS

Endoscopic ultrasound (EUS) is very safe with few risks when performed by gastroenterologists specially trained in this procedure.

What is an EGD?

Recovery. An esophagogastroduodenoscopy (EGD), often referred to as an upper endoscopy, is an invasive procedure that can help in evaluating and managing several conditions that involve the upper gastrointestinal (GI) tract—which is composed of the esophagus, stomach, and upper portion of the small intestine.

Why do you need an EGD?

Purpose of an EGD. An EGD may be done for diagnostic or therapeutic reasons, depending on your condition . Your doctor may recommend an EGD if you have any of the following symptoms: 4. Visualizing the lumen can help identify their cause, which may be otherwise unclear based on presentation alone.

What is EGD used for?

As a diagnostic tool, EGD is also useful when it's the easiest and safest way to obtain a biopsy. During the procedure, your doctor may collect one or more tissue samples so they can be examined under a microscope. 4. Conditions that may be diagnosed or treated with EGD include: 2. Peptic ulcer.

Where is EGD done?

An EGD is typically done in an endoscopy suite, which is a special procedure room. It may be located in the hospital, a surgical center, or an outpatient clinic. You should be prepared to spend several hours at your EGD appointment and to rest for the remainder of the day after your procedure.

What is fiber optic endoscope?

Using the mouth and throat for access, a fiberoptic endoscope equipped with a camera is used to visualize your upper GI tract, obtain a biopsy, or treat gastrointestinal conditions. Illustration by Emily Roberts, Verywell.

When is an upper endoscopy used?

This makes an upper endoscopy a useful adjunct when used along with imaging tests. EGD is also considered when the medical history and physical examination suggest the possibility of a lesion in the lumen that could not be well-visualized with a less invasive test (like an imaging test).

How often do you have to swallow after an endoscope?

When you are adequately relaxed, you will be asked to swallow once or twice during the initial period of insertion of the endoscope. The tube will not interfere with your ability to breathe and is only mildly uncomfortable following the initial insertion.

How long does it take to get an EGD?

EGD is an outpatient procedure, meaning you can go home that same day. It takes approximately 30 to 60 minutes to perform.

Why do we use EGD?

EGD: Why It’s Performed. EGD is used to evaluate a number of digestive disorders. It is a popular diagnostic option because patients generally tolerate it well and it causes minimal discomfort. Your gastroenterologist may use EGD to evaluate: Abdominal pain.

What does EGD mean?

Persistent nausea or vomiting. Swallowing difficulties. Upper gastrointestinal bleeding. Chest pain (without evidence of heart disease) Bloody stool. Your doctor may also order EGD for: Periodic screening, if your doctor thinks you are at risk for developing a digestive disorder.

What to do during an EGD?

When you arrive for the EGD, you will register and give a medical history. We will insert an intravenous line in order to administer fluids and sedatives. During the EGD, your doctor will: Anesthetize your throat with a topical anesthetic to suppress the gag reflex. Administer pain medication and a sedative.

How to get rid of a swollen esophagus?

Administer pain medication and a sedative. Place a plastic mouthpiece between your teeth to prevent damage to the endoscope. Insert the endoscope; as you swallow, the swallowing motion guides the endoscope through your esophagus, stomach and duodenum.

What is EUS used for?

EUS may help in the evaluation of: Cancer of the colon, esophagus, lung, pancreas or stomach, and ampullary and rectal cancers. Lymphoma. Barrett's esophagus. Neuroendocrine tumors. Pancreatitis and pancreatic cysts. Bile duct stones. Sarcoidosis. EUS can help:

What is an EUS?

Endoscopic ultrasound (EUS) is a minimally invasive procedure to assess digestive (gastrointestinal) and lung diseases. A special endoscope uses high-frequency sound waves to produce detailed images of the lining and walls of your digestive tract and chest, nearby organs such as the pancreas and liver, and lymph nodes.

What is the tube used for EUS?

During EUS your doctor passes a thin, flexible tube (endoscope) through your mouth and through your digestive tract. A small ultrasound device (transducer) in the tube produces sound waves that create a precise image of surrounding tissue, including lymph nodes in the chest. The endoscope is then gradually withdrawn.

How does EUS help?

EUS can help: Assess how deeply a tumor penetrates your abdominal wall in esophageal, gastric, rectal, pancreatic and lung cancers. Determine the extent (stage) of cancer, if present. Determine if cancer has spread (metastasized) to your lymph nodes or other organs.

What is the name of the tube that a doctor inserts into the abdomen to perform an ultrasound?

Close. Pancreatic ultrasound. Pancreatic ultrasound. During an endoscopic ultrasound of the pancreas, your doctor inserts a thin, flexible tube (endoscope) down your throat and into your abdomen. An ultrasound device at the end of the tube emits sound waves that generate images of your pancreas and nearby tissues.

Why do we use EUS?

Why it's done. EUS is used to find the cause of symptoms such as abdominal or chest pain, to determine the extent of diseases in your digestive tract and lungs, and to evaluate findings from imaging tests such as a CT scan or MRI. EUS may help in the evaluation of: Cancer of the colon, esophagus, lung, pancreas or stomach, ...

What doctor interprets EUS?

A specialist in digestive diseases (gastroenterologist) or lung disease (pulmonologist) with special training in EUS will interpret the EUS images. A doctor trained in analyzing biopsies (pathologist) will report the test results if you have fine-needle aspiration. Your doctor will discuss any important findings and next steps with you.

Is rygbp a predictor of endoscopic pathology?

In patients who have had RYGBP, symptoms were a poor predictor of endoscopic pathology. Ulcer disease was the most common endoscopic finding. These ulcers were not associated with H. pylori. All ulcers responded well to oral proton pump inhibitors (PPI) and sucralfate therapy.

Is ulcer disease an endoscopic finding?

Ulcer disease was the most common endoscopic finding. These ulcers were not associated with H. pylori. All ulcers responded well to oral proton pump inhibitors (PPI) and sucralfate therapy. The community gastroen …. In patients who have had RYGBP, symptoms were a poor predictor of endoscopic pathology.

Diagnosis

Definition

  • An EUS is a type of endoscopic examination. It involves the insertion of a thin tube into the mouth and down into the stomach and the first part of the small intestine. At the tip of the tube is a small ultrasound probe that emits sound waves. These sound waves bounce off of the surrounding structures, such as the stomach, small intestine, pancreas...
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Causes

  • These findings listed above can be caused by both benign and malignant conditions. Thus, it is important that you discuss the reason for the EUS with your physician.
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Advantages

  • One of the advantages of performing an EUS is that pancreatic biopsies can be obtained at the time of the examination. These biopsies, often referred to as FNA, or fine-needle aspiration, can allow for your physician to collect tissue samples which can later be analyzed under a microscope. Special needles, designed to be used with the EUS scope, allow the physician to ins…
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Usage

  • FNA is most commonly performed to evaluate masses or tumors of the pancreas, in order to determine if cancer is present. Another very common reason for performing an FNA is in the evaluation of pancreatic cysts. In these cases, the needle is used to sample the fluid which is contained in the cyst. This fluid can be sent for biochemical, cytologic, and molecular analysis i…
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Clinical significance

  • In certain circumstances, larger biopsy samples of the pancreas may be required. EUS allows the physician to obtain core biopsies of the pancreas in a similar fashion to FNA.
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Risks

  • Because sedation, or in some cases, general anesthesia is used during EUS, there is a risk for cardiac and/or pulmonary complications during an EUS procedure. As with any endoscopic procedure, there is a small risk of causing bleeding or a tear of the GI tract (called a perforation). These complications can often be managed endoscopically, however emergency surgery may b…
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Preparation

  • On the day of your EUS, you will arrive in the endoscopy suite. An IV catheter will be placed in your hand or arm so that you can receive intravenous fluids and sedatives during the procedure. Once you are brought into the endoscopy room, you will lay down on a bed, usually on your left side (like you are watching TV). In order to monitor your vital signs during the procedure, a blood pressur…
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Results

  • Sedatives will be injected into your IV before the procedure begins. The procedure usually lasts from 20-45 minutes, but can be shorter or longer. The vast majority of patients do not feel or experience any discomfort during the procedure, as they are usually asleep during the procedure. When the procedure is finished, you will be brought to a recovery area where you will lay in bed u…
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