ENDOSKOPI

/OGDS/PROKTOSKOPI/SIGMOIDOSKO
PI/
KOLONSKOPI
Definisi OGDS?

• OGDS (oesophagogastroduodenoscopy) adalah prosedur bagi

pemeriksaan pada bahagian atas salur pemakanan pesakit. Ini
melibatkan pemeriksaan pada bahagian esofagus, perut dan
duodenum. Prosedur OGDS ini melibatkan penggunaan kabel gentian
optik yang dipasangkan kamera pada hujungnya dan dimasukkan
melalui mulut pesakit.
• Merupakan prosedur invasive
indikasi
• Penilaian diagnostic
• Sukar/sakit ketika menelan makanan
• Dyspepsia
• Non cardiac chest pain
• Recurent emesis
• Saringan kanser
• Muntah berdarah
• Sakit terutamanya pada bahagian atas perut
• Simptom reflux yang berpanjangan
• Kanser
• Pendarahan pada bahagian perut
• Hiatus Hernia
• Ulser pada bahagian perut/duodenum
• Biposy –malabsorption syndrome /neuplasma
• Therapeutic intervention –retrieval of foreign body , dilatation pr
stenting of stricture
Kontraindikasi
• Perforation
• Head and neck surgery
• Anticoagulation
• Pharyngeal diverticulum
Complication

• Aspiration pneumonia
• Bleeding
• Perforation
• Cardiopulmonary problem
Equipment

• Endoscope
• Stack - light source
• - insufflators
• - suction
• Instruments - biopsy forceps
• - snares
• - injecting needles
Before procedure

• Keep patient NBM (nil by mouth)

• Obtain consent from the patient (risk for
• bleeding and perforation)
• Take blood for investigation - complete blood
• cell count, blood cross matching, coagulation
• studies, BUSE, electrocardiogram, and chest
• radiographs.
• Take vital sign for baseline
During procedure

• Placed patient in the left lateral position.

• Administer topical and/or intravenous sedation to
• minimize gagging and to facilitate the procedure.
• Place a bite block (mouth guard) to prevent
• damage to the endoscope and to ease its passage
• through the mouth.
• Under direct vision, the endoscope will passed
• through the pharynx, esophagus, stomach and
• duodenum.
• Liquid and particulate matter can be aspirated
• through the suction channel.
• The procedure and findings will be documented
• with pictures or a video system. Biopsy specimens
• can be obtained by passing forceps and taking
• small mucosal samples for histology studies.
• The procedure may last _at_ 5-30 minutes
After procedure

• Close monitoring of vital sign for 1 2 hours,

• or until the sedative or analgesia has worn off.
• Keep patient nil by mouth until the local
• anesthetic has worn off (in the throat) and the
• gag reflex has returned (after two to four hours)
• Patient may complaint of hoarseness and a mild
• sore throat - drink cool fluids or gargle to
• relieve the soreness
Sigmoidoscopy, Colonoscopy And Biopsy

• Definitions
• Colonoscopy is the endoscopic examination of the
• colon and the distal part of the small bowel
• Sigmoidoscopy is the medical examination of the
• large intestine from the rectum up to the sigmoid
• A biopsy is a removal of tissue to determine the
• presence or extent of a disease.
COLONOSCOPY
Indication

• Rectal bleeding
• Iron deficiency anaemia
• Cancer follow-up
• Polyp follow-up
• Abdominal pain
• Abnormal bowel habit
SIGMOIDOSCOPY

• Symptoms that suggest anorectal pathology,

• including colorectal neoplasia
• Prior to anorectal procedures
• To obtain biopsy of any bowel condition
• To assess the true height (distance from anal
• verge) of rectal cancers
• Conservative treatment of sigmoid volvulus
• During anterior resection of rectum to gauge the
• lower resection margin
Before procedure

• Stop
• Aspirin and drugs for arthritis (ibuprofen,
• naproxen, etc.) A week before the procedure to
• prevent intestinal bleeding
• Iron pills, because it may cause constipation
• difficult for colon cleansing
• Barium swallow or enema, because barium can cover
• intestinal mucosa thus hiding it from doctors
• view
• Anticoagulants to prevent risk of bleeding
• Insulin should not be taken during fasting
• Bowel preparation
• Low residue diet 2-3 days pre operatively
• Administration of glycol-electrolyte solution
• (Go-LYTELY) x 2 bottles / Foltran / fleet
• solution _at_ 1 day pre op (evening).
• Clear fluids only after administration of
• Go-LYTELY
• Bowel washout _at_ morning of operation day (if
• necessary)
During procedure

• Lie on left lateral

• Sedation will be given if necessary
• Doctor will administer the colonoscope through
• your anus into the colon and advance it toward
• the end of the colon.
• If necessary, doctor will perform a biopsy, stop
• the bleeding or remove the polyp.
• Investigation lasts about 30-45 minutes
After procedure

• Rest for 1 2 hours

• Patient may experience some cramping or bloating
• (due to inflated air during the procedure) for
• the next day or 1-2 days
• Biopsy results will be ready in a week
Komplikasi
• Perforation
• Mucosal tear
• Bleeding
• Abdominal discomfort
• diagnose a disease in your rectum or anus, including cancer
• find the cause of bleeding from the rectum
• diagnose hemorrhoids
• remove a sample of tissue for testing, called a biopsy
• find and remove polyps and other abnormal growths
• monitor rectal cancer after surgery or other treatments
• Proctoscopy is a procedure used to diagnose problems with your rectum and
anus. The rectum is the end of your large intestine (colon). The anus is the
opening of the rectum.

• The device used to perform this procedure is a hollow tube called a

proctoscope. A light and lens on the device lets your doctor examine the
inside of your rectum.

• This procedure is also called rigid sigmoidoscopy. It’s different from a flexible
sigmoidoscopy, which is another type of procedure used to diagnose
problems with the lower portion of the colon.
complication
• infection
• belly pain
• a tear in the rectum (this is rare)