EGD - esophagogastroduodenoscopy

ʻO ka Esophagogastroduodenoscopy (EGD) kahi hoʻāʻo e nānā i ka lining o ka esophagus, ʻōpū, a me ka ʻāpana mua o ka ʻōpū liʻiliʻi (ka duodenum).

Hana ʻia ʻo EGD i kahi haukapila a i ʻole kahi kikowaena olakino. Hoʻohana ke kaʻina hana i kahi endoscope. ʻO kēia kahi paipu maʻalahi me kahi kukui a me ka pahu paʻi kiʻi ma ka hopena.

Hana ʻia ke ʻano hana penei:

• I ke kaʻina hana, nānā ʻia kou hanu ʻana, ka helu o ka puʻuwai, ke kahe o ke koko, a me ka pae o oxygen. Hoʻopili nā kaula i kekahi mau wahi o kou kino a laila i nā mīkini e nānā i kēia mau hōʻailona koʻikoʻi.
• Loaʻa ʻoe i ka lāʻau i loko o ke aa e kōkua iā ʻoe e hoʻomaha. ʻAʻole ʻoe e ʻehaʻeha a hoʻomanaʻo ʻole i ke kaʻina hana.
• E kāpī ʻia kahi anesthetic kūloko i loko o kou waha e pale aku ai iā ʻoe mai ka huehue a i ʻole ke ʻūlū ʻana ke hoʻokomo ʻia ka laulā.
• Hoʻohana ʻia kahi kiaʻi waha e pale i kou mau niho a me ke ākea. Pono e hemo nā niho ma mua o ka hoʻomaka ʻana o ke kaʻina hana.
• E moe ʻoe ma kou ʻaoʻao hema.
• Hoʻokomo ʻia ka laulā ma o ka esophagus (paipu meaʻai) i ka ʻōpū a me ka duodenum. ʻO ka duodenum ka ʻāpana mua o ka ʻōpū liʻiliʻi.
• Hoʻokomo ʻia ka ea ma o ka laulā e maʻalahi ai ka ʻike a ke kauka.
• Nānā ʻia ka uhi o ka esophagus, ʻōpū, a me ka duodenum luna. Hiki ke lawe ʻia nā biopsies ma o ka laulā. ʻO Biopsies kahi laʻana kikoʻī e nānā ʻia ma lalo o ka microscope.
• Hiki ke hana i nā ʻano lawelawe like ʻole, e like me ke kīloi ʻana a hoʻonui ʻana paha i kahi ʻikiʻī o ka esophagus.

Ma hope o ka pau ʻana o ka hoʻāʻo, ʻaʻole hiki iā ʻoe ke loaʻa ka meaʻai a me ka wai a hiki i ka hoʻi ʻana o kāu gag reflex (no laila ʻaʻole ʻoe e choke).

Lōʻihi ka hōʻike ma kahi o 5 a 20 mau minuke.

E hāhai i nā ʻōkuhi āu i hāʻawi ʻia ai no ka hoʻi hou ʻana ma ka home.

ʻAʻole hiki iā ʻoe ke ʻai i kekahi mea no 6 a 12 mau hola ma mua o ka hoʻāʻo. E hāhai i nā ʻōkuhi e pili ana i ka hoʻokū ʻana i ka aspirin a me nā lāʻau hoʻomāliʻi koko aʻe ma mua o ka hoʻāʻo.

Hana ka ʻehu anesthetic i mea paʻakikī e ale. Pau kēia ma hope koke iho o ke kaʻina hana. Hiki iā ʻoe ke gag.

ʻIke paha ʻoe i ka ʻaukā a me ka neʻe ʻana o ka laulā i loko o kou ʻōpū. ʻAʻole hiki iā ʻoe ke ʻike i ka biopsy. Ma muli o ka sedation, ʻaʻole paha ʻoe e ʻike i kahi hōʻoluʻolu a ʻaʻohe ou hoʻomanaʻo o ka hoʻāʻo.

Paha paha ʻoe i ka ea mai ka lewa i hoʻokomo ʻia i kou kino. Pau koke kēia manaʻo.

Hana ʻia paha ʻo EGD inā loaʻa iā ʻoe kahi hōʻailona hou, ʻaʻole hiki ke wehewehe ʻia, a i ʻole ke pane ʻana i ka mālama ʻana, e like me:

• ʻO nā noho ʻeleʻele a i ʻole hoʻoluhi koko paha
• Ke lawe nei i ka meaʻai i hope (regurgitation)
• ʻOi ka piha ma mua o ka maʻamau a ma hope paha o ka ʻai ʻana ma mua o ka maʻamau
• Paʻa ka manaʻo e like me ka meaʻai ma hope o ka umauma
• Puʻuwai puʻuwai
• Helu koko haʻahaʻa (anemia) i hiki ʻole ke wehewehe ʻia
• ʻEha a ʻoluʻolu ʻole i loko o ka ʻōpū luna
• Ke ale nei i nā pilikia a i ʻole ka ʻeha me ka ale ʻana
• ʻO ke kaupaona hiki ʻole ke wehewehe ʻia
• Nusea a i ʻole ka luaʻi e hele ʻole

E kauoha paha kāu kauka i kēia hōʻike inā ʻoe:

• Loaʻa i ka cirrhosis o ke ake, e nānā i nā veins pehu (i kapa ʻia he varices) i loko o nā paia o ka ʻaoʻao haʻahaʻa o ka esophagus, a hoʻomaka paha e kahe i ke koko.
• Loaʻa iā Crohn maʻi
• Pono hou i ka ukali a i ʻole ka lapaʻau ʻana no kahi kūlana i ʻike ʻia

Hiki ke hoʻohana ʻia ka hōʻike e lawe i kahi ʻāpana o ke kiko no ka biopsy.

ʻO ka esophagus, ʻōpū, a me ka duodenum e laumania a me ke kala maʻamau. ʻAʻole pono ke kahe ʻana o ka toto, ka ulu ʻana, ka maʻi ulcer, a me ka mumū.

He hopena EGD paha ka hopena o:

• Maʻi Celiac (ʻinoʻino i ka uhi ʻana o ka ʻōpū liʻiliʻi mai kahi hopena i ka ʻai ʻana i ka gluten)
• Nā ʻekena esophageal (nā aʻa pehu i ka uhi o ka esophagus i hoʻokumu ʻia e ka cirrhosis ate)
• Esophagitis (ka uhi ʻana o ka esophagus lilo i puhi a pehu paha)
• Gastritis (lining o ka ʻōpū a me ka duodenum ua hoʻāhā a pehu paha)
• ʻO ka maʻi reflux Gastroesophageal (kahi ʻano e kulu hope ai ka meaʻai a wai paha mai ka ʻōpū i loko o ka esophagus)
• Hiatal hernia (kahi ʻano o ka ʻōpū e paʻa ai i ka umauma ma o ka wehe ʻana i ka diaphragm)
• Mallory-Weiss maʻi (haehae i ka esophagus)
• Pahu o ka esophagus, e like me ke ʻano i kapa ʻia he apo esophageal
• Nā Tumors a i ʻole ka maʻi ʻaʻai i ka esophagus, ʻōpū, a i ʻole duodenum (ʻāpana mua o ka ʻōpū liʻiliʻi)
• Ulcer, gastric (ʻōpū) a i ʻole duodenal (ʻōpū liʻiliʻi)

Aia kahi manawa liʻiliʻi o kahi puka (perforation) i loko o ka ʻōpū, duodenum, a i ʻole esophagus mai ka pae e neʻe ana i kēia mau wahi. Aia kekahi wahi liʻiliʻi o ke kahe ʻana o ke kahe ma ka pūnaewele biopsy.

Hiki iā ʻoe ke pane i ka lāʻau i hoʻohana ʻia i ke kaʻina hana, i hiki ke kumu:

• ʻAno (ʻaʻole hanu)
• Hanu paʻakikī (hanu kaumaha)
• Nui ka hou ʻana i ka hou
• Ke koko haʻahaʻa (hypotension)
• Pāloli ka naʻau (bradycardia)
• Spasm o ka larynx (laryngospasm)

ʻO Esophagogastroduodenoscopy; Endoscopy luna; Gastroscopy

• Reflux Gastroesophageal - hoʻokuʻu

• Endoscopy Gastric
• ʻO Esophagogastroduodenoscopy (EGD)

Koch MA, Zurad EG. ʻO Esophagogastroduodenoscopy. I: Fowler GC, hoʻoponopono. ʻO Pfenninger & Fowler's Procedures no ka mālama mua. ʻEhā ed. Piladelapia, PA: Elsevier; 2020: chap 91.

ʻO Vargo JJ. Hoʻomākaukau a me nā pilikia o ka GI endoscopy. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi Liver: Pathophysiology / Diagnosis / Management. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 41.