Barrett's esophagus other imaging findings: Difference between revisions

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{{Barrett's esophagus}}
{{Barrett's esophagus}}


{{CMG}}; {{AE}} {{HQ}}
{{CMG}}; {{AE}} {{HQ}} {{AMK}}


==Overview==
==Overview==
There are no other imaging findings associated with [disease name].
Unsedated [[esophagoscopy]] and capsule [[esophagoscopy]] may be helpful in the diagnosis of Barrett's esophagus.


OR
==Other Imaging Findings==
===Unsedated Esophagoscopy===
*Using local [[anesthesia]] with aerosolized 4% [[lidocaine]] and [[oxymetazoline]] hydrochlorine a small-caliber upper endoscope passed transorally or transnasally into the [[esophagus]] with [[Anesthesia|topical anesthesia]].<ref name="Wilkins2005">{{cite journal|last1=Wilkins|first1=T.|title=Office-Based Unsedated Ultrathin Esophagoscopy in a Primary Care Setting|journal=The Annals of Family Medicine|volume=3|issue=2|year=2005|pages=126–130|issn=1544-1709|doi=10.1370/afm.262}}</ref><ref name="JobeHunter2006">{{cite journal|last1=Jobe|first1=Blair A.|last2=Hunter|first2=John G.|last3=Chang|first3=Eugene Y.|last4=Kim|first4=Charles Y.|last5=Eisen|first5=Glenn M.|last6=Robinson|first6=Jedediah D.|last7=Diggs|first7=Brian S.|last8=O'Rourke|first8=Robert W.|last9=Rader|first9=Anne E.|last10=Schipper|first10=Paul|last11=Sauer|first11=David A.|last12=Peters|first12=Jeffrey H.|last13=Lieberman|first13=David A.|last14=Morris|first14=Cynthia D.|title=Office-Based Unsedated Small-Caliber Endoscopy Is Equivalent to Conventional Sedated Endoscopy in Screening and Surveillance for Barrett's Esophagus: A Randomized and Blinded Comparison|journal=The American Journal of Gastroenterology|volume=101|issue=12|year=2006|pages=2693–2703|issn=0002-9270|doi=10.1111/j.1572-0241.2006.00890.x}}</ref>


[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
*Aaerosolized 14% [[benzocaine]] is instilled into the oropharynx for 3 seconds.
*4.9 mm diameter flexible endoscope with a 2 mm working channel is passed transnasally through the nasal turbinate into the [[oropharynx]], [[hypopharynx]], [[esophagus]], and [[stomach]].  


==Other Imaging Findings==
===Capsule Esophagoscopy===
===UNSEDATED ESOPHAGOSCOPY===
*The esophageal capsule is swallowed and allows for capture of 14 images per second by using two optical domes.<ref name="DelvauxGay2008">{{cite journal|last1=Delvaux|first1=Michel|last2=Gay|first2=Gérard|title=Capsule endoscopy: Technique and indications|journal=Best Practice & Research Clinical Gastroenterology|volume=22|issue=5|year=2008|pages=813–837|issn=15216918|doi=10.1016/j.bpg.2008.06.003}}</ref><ref name="De JongeVan Eijck2009">{{cite journal|last1=De Jonge|first1=Pieter J. F.|last2=Van Eijck|first2=Brechje C.|last3=Geldof|first3=Han|last4=Bekkering|first4=Frank C.|last5=Essink-Bot|first5=Marie-Louise|last6=Polinder|first6=Suzanne|last7=Kuipers|first7=Ernst J.|last8=Siersema|first8=Peter D.|title=Capsule endoscopy for the detection of oesophageal mucosal disorders: a comparison of two different ingestion protocols|journal=Scandinavian Journal of Gastroenterology|volume=43|issue=7|year=2009|pages=870–877|issn=0036-5521|doi=10.1080/00365520801908878}}</ref>
*Using local anesthesia with aerosolized 4% lidocaine and oxymetazoline hydrochlorine a small-caliber upper endoscope passed transorally or transnasally into the esophagus with topical anesthesia
*Patient takes sips of water every 30 seconds during the 3 minutes with the patient lying in the right lateral [[supine]] position which provides better visualization of the z-line.  
*We use an atomizer to instill 7 mL of aerosolized 4% lidocaine and 0.05% oxymetazoline hydrochloride into the patent nares over five minutes.
*Next, we administer a 3-second instillation of aerosolized 14% benzocaine into the oropharynx.  
*We then have the patient put their chin to their chest and pass a 4.9 mm diameter flexible endoscope with a 2 mm working channel transnasally through the nasal turbinates and into the oropharynx, hypopharynx, esophagus, and stomach.
*We have found that the 5 mm caliber scope that we use remains tolerable and allows for biopsies to be taken at the time of unsedated exam, obviating the need for sedated EGD if non-dysplastic BE is discovered.


==References==
==References==

Latest revision as of 18:56, 21 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2] Amresh Kumar MD [3]

Overview

Unsedated esophagoscopy and capsule esophagoscopy may be helpful in the diagnosis of Barrett's esophagus.

Other Imaging Findings

Unsedated Esophagoscopy

  • Aaerosolized 14% benzocaine is instilled into the oropharynx for 3 seconds.
  • 4.9 mm diameter flexible endoscope with a 2 mm working channel is passed transnasally through the nasal turbinate into the oropharynx, hypopharynx, esophagus, and stomach.

Capsule Esophagoscopy

  • The esophageal capsule is swallowed and allows for capture of 14 images per second by using two optical domes.[3][4]
  • Patient takes sips of water every 30 seconds during the 3 minutes with the patient lying in the right lateral supine position which provides better visualization of the z-line.

References

  1. Wilkins, T. (2005). "Office-Based Unsedated Ultrathin Esophagoscopy in a Primary Care Setting". The Annals of Family Medicine. 3 (2): 126–130. doi:10.1370/afm.262. ISSN 1544-1709.
  2. Jobe, Blair A.; Hunter, John G.; Chang, Eugene Y.; Kim, Charles Y.; Eisen, Glenn M.; Robinson, Jedediah D.; Diggs, Brian S.; O'Rourke, Robert W.; Rader, Anne E.; Schipper, Paul; Sauer, David A.; Peters, Jeffrey H.; Lieberman, David A.; Morris, Cynthia D. (2006). "Office-Based Unsedated Small-Caliber Endoscopy Is Equivalent to Conventional Sedated Endoscopy in Screening and Surveillance for Barrett's Esophagus: A Randomized and Blinded Comparison". The American Journal of Gastroenterology. 101 (12): 2693–2703. doi:10.1111/j.1572-0241.2006.00890.x. ISSN 0002-9270.
  3. Delvaux, Michel; Gay, Gérard (2008). "Capsule endoscopy: Technique and indications". Best Practice & Research Clinical Gastroenterology. 22 (5): 813–837. doi:10.1016/j.bpg.2008.06.003. ISSN 1521-6918.
  4. De Jonge, Pieter J. F.; Van Eijck, Brechje C.; Geldof, Han; Bekkering, Frank C.; Essink-Bot, Marie-Louise; Polinder, Suzanne; Kuipers, Ernst J.; Siersema, Peter D. (2009). "Capsule endoscopy for the detection of oesophageal mucosal disorders: a comparison of two different ingestion protocols". Scandinavian Journal of Gastroenterology. 43 (7): 870–877. doi:10.1080/00365520801908878. ISSN 0036-5521.

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