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1. OESOPHAGOSCOPY
B y R a a f i U l B a s h e e r Z a r g a r

2.  INTRODUCTION
 TYPES
 INDICATIONS
 CONTRAINDICATIONS
 ANESTHESIA
 POSITION
 TECHNIQUE
 STRUCTURES SEEN
 POSTOPERATIVE CARE
 COMPLICATIONS
 OVERVIEW

3. IT’S A PROCEDURE TO EXAMINE THE
OESHPHAGUS FOR DIAGNOSTIC AND
THERAPEUTIC PURPOSES
 INTRODUCTION

4. 1.RIGID OESOPHAGOSCOPY
2.FLEXIBLE FIBREOPTIC OESOPHAGOSCOPY
3.TRANSNASAL OESOPHAGOSCOPY
 TYPES

5. TO INVESTIGATE CAUSE OF:
-DYSPHAGIA
-RETROSTERNAL PAIN
-HAEMATEMESIS
-SECONDARIES OF NECK
DIAGNOSTIC
 INDICATIONS

6. -REMOVAL OF FOREIGN BODY
-DILATATION OF THE OESOPHAGUS
-ENDOSCOPIC REMOVAL OF BENIGN
LESIONS
-INSERTION OF SOUTTAR’S OR MOUSSEAU-
BARBIN TUBE IN PALLIATIVE TREATMENT
OF OESOPHAGEAL CA
-INJECTION OF OESOPHAGEAL VARICES
THERAPEUTIC

7. 1.TRISMUS
2.DISEASES OF CERVICAL SPINE
3.RECEDING MANDIBLE
4.ANEURYSM OF AORTA
5.HEART, LIVER OR KIDNEY DISEASES
 CONTRAINDICATIONS

8. PATIENT ADVISED NOTHING TO EAT 3
HOURS PRIOR TO THE PROCEDURE
 PATIENT PREPARATION

9. 1. RIGID OESOPHAGOSCOPY
 TYPES

10. GENRAL ANESTHESIA WITH
ENDOTRACHEAL INTUBATION
ANESTHESIA
POSITION
SWORD SWALLOING POSITION

11. PROTECTION OF LIPS & TEETH
LUBRICATION OF SCOPE
HOLDING OF THE SCOPE
IDENTIFICATION OF LARYNGOPHARYNX STRUCTURES
ADVANCEMENT FURTHER INTO CRICOPHARYNGEAL SPHINCTER
CROSSING AORTIC ARCH & LEFT BRONCHUS
PASSING THE CARDIA & FOLLOWED BY WITHDRAWL
TECHNIQUES

13. 1.FEATUERES OF OESOPHAGEAL
PERFORATION-INTRASCAPULAR PAIN
-SURGICAL EMPHYSEMA OF NECK
-ABRUPT RISE IN TEMP.
2.DIET-SIPS OF PLAIN WATER FOLLOWED BY USUAL DIET
 POSTOPERATIVE CARE

14. 1.INJURY TO LIPS AND TEETH
2.INJURY TO ARYTENOIDS
3.INJURY TO PHARYNGEAL MUSCLES
4.PERFORATION OF ESOPHAGUS
5.COMPRESSION OF TRACHEA
 COMPLICATION

15. 1.MORE AMENABLE TO THERAPEUTIC
INDICATIONS ESPECIALLY REMOVAL OF
FOREIGN BODIES.
2.BETTER VISUALIZATION OF PROXIMAL ONE-THIRD
OF ESOPHAGUS.
 ADVANTAGES

16. 1.GENERAL ANAESTHESIA.
2.MORE COST AND MORBIDITY TO PATIENT.
3.MORE COMPLICATIONS SUCH AS
4.DENTAL TRAUMA AND OESOPHAGEAL
PERFORATION.
5.CONCOMITANT EXAMINATION OF STOMACH
AND INTESTINE NOT POSSIBLE.
6.NOT AMENABLE TO CASES OF TRISMUS OR
CERVICAL SPINE DEGENERATIVE DISEASES.
DISADVANTAGES

17. 2. FLEXIBLE FIBEROPTIC ESOPHAGOSCOPY

18.  POSITION
LEFT LATERAL SUPINE POSITION WITH EXTENDED NECK
 ANESTHESIA
PERFORMED UNDER LOCAL ANESTHESIA WITH OR
WITHOUT SEDATION
 TECHNIQUE
SAME AS RIGID ESOPHAGOSCOPY

19. 1.AN OUTDOOR PROCEDURE.
2.NO GENERAL ANESTHESIA. IT IS DONE UNDER
LOCAL ANESTHESIA WITH OR WITHOUT
INTRAVENOUS SEDATION.
3.LESS MORBIDITY.
4.IT CAN BE DONE IN ABNORMALITIES OF SPINE OR
JAW.
5.GASTROSCOPE ALLOWS EXAMINATION OF
STOMACH AND DUODENUM.
6.GOOD ILLUMINATION AND MAGNIFICATION.
7.ACCURATE DIAGNOSIS OF THE MUCOSAL
DISEASES.
ADVANTAGES

20. 1.NARROW CHANNEL LIMITS THE SIZE OF
INSTRUMENTS AND REMOVALOF CERTAIN
FOREIGN BODIES.
2.FOREIGN BODY CANNOT BE RETRACTED INTO
THE ENDOSCOPE(LIKE RIGID
ESOPHAGOSCOPE) SO MORE CHANCES OF
INJURINGESOPHAGUS.
3.LARYNGOPHARYNX AND PROXIMAL ONE- THIRD
ESOPHAGUS (LESS DISTENSIBLE WITH
INSUFFLATIONS) MAY NOT BE EXAMINED
ADEQUATELY.
 DISADVANTAGES

21. 3. TRANSNASAL OESOPHAGOSCOPY

22.  ANESTHESIA
• TOPICAL
1.NOSE: 4% LIDOCAINE
2.OROPHARYNX:20% BENZOCAINE
 POSITION
• SEATED POSITION FACING EXAMINER

23. SCOPE PASSED ALONG FLOOR OF NOSE
IPSILATERAL PYRIFORM SINUS
ADVANCEMENT INTO ESOPHAGUS
INSUFFLATION OF ESOPHAGUS
FURTHER ADVANCEMNT OF SCOPE INTO STOMACH
SCOPE RETROFLEXED TO SEE COMPLETE VIEW OF GE JUNCTION
WITHDRAWL
TECHNIQUES

25. 1.IMPROVED SAFETY
2.DECREASED OVERALL COSTS
3.PATIENT PREFERENCE
 ADVANTAGES

26. 1.MULTIPLE BIOPSIES
2.VESSEL LIGATIONS
3.MANY THERAPEUTIC INSTRUMENTS
 DISADVANTAGES

27. THANK YOU