Practical Pediatric Gastrointestinal Endoscopy

by George Gershman (David Geffen School of Medicine at UCLA); Marvin Ament (David Geffen School of Medicine at UCLA)

• ISBN13: 9781405131933
• ISBN10: 1405131934
• Edition: 1st
• Format: Hardcover
• Copyright: 2007-01-01
• Publisher: Wiley-Blackwell

Summary

Practical Pediatric Gastrointestinal Endoscopy is the only text available that provides detailed instructions of all practical aspects of diagnostic and therapeutic endoscopic procedures in children. It gives detailed descriptions of the investigation, diagnosis and therapeutic pediatric GI endoscopy treatments with special attention to the differences between instruments used for adults and for pediatric patients. The advice is based on unique personal experience of thousands of endoscopic or colonoscopic procedures, written by a team of authors with experience in performing the diagnostic and therapeutic endoscopic procedures in children and infants of all ages. The key points of each step are accompanied by easy-to-follow color diagrams and a comprehensive atlas of endoscopic images, illustrating both normal and abnormal pathology, aiding and perfecting diagnosis and treatment. The step-by-step description of each procedure explains the purpose of each maneuvre, with much greater emphases on the practical aspects of diagnostics and therapeutic procedures to provide the best results and maximize patient safety. It looks at patient care before, during and after procedures and considers the new and less invasive Wireless Capsule Endoscopy options that will be less traumatic for the pediatric patient.

Author Biography

Dr George Gershman, Associate Professor of Pediatrics and Chief of the Division of Pediatric Gastroenterology and Nutrition, Harbor-UCLA Medical Center, Los Angeles, USA.

Dr Marvin Ament, Professor of Pediatrics and Chief of the Division of Pediatric Gastroenterology, Hepatology and Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, USA.

Table of Contents

Contributors,	viii
1 Introduction,	1
2 Settings and Staff,	2
The endoscopy unit,	2
Pediatric endoscopy nurse,	3
Disinfections of the endoscopes and accessories,	4
Documentation,	4
Further reading,	5
3 Equipment,	6
Overview,	6
Insertion tube,	6
Video image capture,	16
"Reading" the image created on the CCD,	18
Types of CCDs,	20
History of endoscope CCD development,	21
Shape of displayed image,	22
Reproduction of color,	23
Reproduction of motion,	32
Transillumination,	33
Laser therapy with video endoscopes,	33
Image resolution,	34
Color reproduction accuracy,	35
Troubleshooting,	35
Endoscope reprocessing,	35
Summary,	43
Further reading,	43
4 Patient Preparation,	45
Pediatric-monitored sedation and anesthesia for diagnostic and therapeutic procedures in endoscopy,	46
During sedation,	51
Postsedation care,	52
Specific sedation techniques,	52
Further reading,	57
5 Diagnostic Upper Endoscopy Technique,	60
Preparation for esophageal intubation,	60
Assembling the equipment and preprocedure checkup,	61
Endoscope handling,	62
Technique of esophageal intubation,	63
Indications for upper endoscopy,	77
Push enteroscopy/jejunoscopy,	94
Further reading,	97
6 Therapeutic Upper GI Endoscopy,	102
Benign esophageal stricture,	102
Pneumatic dilation in achalasia,	103
Foreign bodies,	105
Endoscopic hemostasis,	109
Percutaneous endoscopic gastrostomy,	117
Nasojejunal tube placement,	125
Further reading,	127
7 Pediatric Colonoscopy,	132
Introduction,	132
Indications for colonoscopy,	132
Preparation of the patient for colonoscopy,	134
Equipment,	137
Magnetic imaging system,	138
Informed consent and preprocedure preparation,	139
Sedation for colonoscopy,	139
Embryology of the colon,	140
Endoscopic anatomy,	142
Torque-steering technique,	147
Exploration of the sigmoid colon and sigmoid—descending junction,	152
Splenic flexure and transverse colon,	154
Hepatic flexure, ascending colon, and cecum,	155
Terminal ileum,	156
Complications,	157
Common pathology,	159
Further reading,	168
8 Polypectomy,	171
Basic principles of electrosurgery,	171
Snare loops,	173
Polypectomy routine,	175
Safety routine,	175
Safety conditions and techniques,	176
Complications,	180
Further reading,	180
9 Chromoendoscopy,	181
Indications,	181
Application technique,	184
Recognition of the lesions,	189
Further reading,	193
10 Wireless Capsule Endoscopy,	194
History,	194
The GIVEN M2A system,	194
Localization,	195
Suspected blood indicator,	196
Indication for use,	196
Diagnostic yield,	196
Contraindications to capsule endoscopy,	197
Pacemaker safety,	197
Bowel preparation,	197
Promotility agents,	198
Endoscopic assistance,	198
Complications,	198
Outcome of capsule endoscopy,	198
Pediatric patients,	198
Further reading,	199
Index,	201