EGD -食管胃十二指肠镜检查

定义

食道、胃、十二指肠镜检查 (EGD) is a test to examine the lining of the esophagus, 胃, and first part of the small intestine (the 十二指肠).

选择的名字

食道、胃、十二指肠镜检查; Upper endoscopy; Gastroscopy; EGD

如何执行测试

EGD is done in a hospital or outpatient center by a specially trained doctor called a gastroenterologist. 该手术使用内窥镜. This is a flexible tube with a light and camera at the end.

操作步骤如下:

• During the procedure, your breathing, heart rate, blood pressure, and oxygen level are checked. Wires are attached to certain areas of your body and then to machines that monitor these vital signs.
• 你收到 药物注入静脉，帮助你放松. You should feel no pain and not remember the procedure.
• A local anesthetic may be sprayed into your mouth to prevent you from coughing or gagging when the scope is inserted.
• A mouth guard is used to protect your teeth and the scope. Dentures must be removed before the procedure begins.
• 然后向左侧卧.
• The scope is inserted through the esophagus (food pipe) to the 胃 and 十二指肠. The 十二指肠 is the first part of the small intestine.
• Air is put through the scope to make it easier for your doctor to see.
• The lining of the esophagus, 胃, and upper 十二指肠 is examined. 活组织检查 可以通过瞄准镜吗. 活组织检查 are tissue samples that are looked at under the microscope for signs of disease.
• Different treatments may be done, such as stretching or widening a narrowed area of the esophagus.

测试结束后, you will not be able to have food and liquid until your gag reflex returns (so you do not choke).

测试持续约5至20分钟.

遵守任何 指令 你天生就适合在家休养.

如何准备考试

You will not be able to eat anything for 6 to 12 hours before the test. Follow 指令 about stopping aspirin and other blood-thinning medicines before the test.

考试的感觉如何

The anesthetic spray makes it hard to swallow. 这种情况在手术后不久就会消失. 瞄准镜可能会让你呕吐.

You may feel gas and the movement of the scope in your abdomen. 你将感觉不到活检. Because of sedation, you may not feel any discomfort and have no memory of the test.

You may feel bloated from the air that was put into your body. 这种感觉很快就会消失.

为什么要进行测试

EGD may be done if you have symptoms that are new, 无法解释, 或者治疗无效, 如:

• 黑色或柏油大便或 吐血
• 将食物带回(反流)
• Feeling full sooner than normal or after eating less than usual
• Feeling like food is stuck behind the breastbone
• 胃灼热
• 低血球计数(贫血)无法解释
• 上腹部疼痛或不适
• Swallowing problems or pain with swallowing
• 无法解释的体重减轻
• 恶心或呕吐持续不退

Your health care provider may also order this test if you:

• 有 肝硬化 肝脏的, to look for swollen veins (called varices) in the walls of the lower part of the esophagus, 哪一个可能开始出血
• 有 克罗恩病
• Need more follow-up or treatment for a condition that has been diagnosed

The test may also be used to take a piece of tissue for biopsy.

正常的结果

The esophagus, 胃, and 十二指肠 should be smooth and of normal color. There should be no bleeding, growths, ulcers, or inflammation.

异常结果意味着什么

异常的EGD可能是以下原因造成的:

• 乳糜泻 (damage to the lining of the small intestine from a reaction to eating gluten)
• Esophageal varices (swollen veins in the lining of the esophagus caused by 肝硬化)
• 食管炎 (lining of the esophagus becomes inflamed or swollen)
• 胃炎 (lining of the 胃 and 十二指肠 is inflamed or swollen)
• 胃食管反流病 (a condition in which food or liquid from the 胃 leaks backward into the esophagus)
• 食管裂孔疝 (a condition in which part of the 胃 sticks up into the chest through an opening in the diaphragm)
• Mallory-Weiss综合症 (食道撕裂)
• Narrowing or stricture of the esophagus, such as from a condition called an 食管环
• Tumors or cancer in the esophagus, 胃, or 十二指肠 (first part of small intestine)
• 溃疡, gastric (胃) or duodenal (small intestine)

风险

There is a small chance of a hole (perforation) in the 胃, 十二指肠, or esophagus from the scope moving through these areas. There is also a small risk of bleeding at the biopsy site.

You could have a reaction to the medicine used during the procedure, which could cause:

• 呼吸暂停 (不是呼吸)
• 呼吸困难 (呼吸道抑郁症)
• 过度出汗
• 低血压(低血压)
• 心跳缓慢(心动过缓)
• 喉痉挛(喉痉挛)

参考文献

科赫MA，祖拉德EG. 食道、胃、十二指肠镜检查. 见:福勒GC编. Pfenninger & 福勒初级保健程序. 第四版. Philadelphia, PA: Elsevier; 2020:chap 91.

Sugumar A, Vargo JJ. Preparation for and complications of gastrointestinal endoscopy. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11日艾德. Philadelphia, PA: Elsevier; 2021:chap 42.