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[Transnasal esophagogastroduodenoscopy?]
András Taller1, Emilia Horváth, Lajos Iliás
1Fóvárosi Onkormányzat Uzsoki utcai Kórháza, Budapest, II. sz. Belgyógyászat. ataller@pluto.gamax.hu
Introduction:
The most proper examination for the morphological changes of the upper gastrointestinal tract is endoscopy. The standard oro-gastric route is carried out under conscious sedation, but the drugs used might have cardiopulmonary side effects. Furthermore there are a few conditions when this routine endoscopy is technically impossible.
Aims:
Could these failures be avoided with an endoscope led through the nose? Are there advantages of the use of ultrathin endoscopes for transnasal oesophago-gastro-duodenoscopy?
Patients/Methods:
Own experiences with transnasal therapeutic endoscopies on patients with cancer in the head and neck region compared with data from the literature.
Results:
Based on literature and on own experiences, transnasal oesophago-gastro-duodenoscopy may be advised in cases with trismus, stenosis of the upper aero-digestive tract, oropharyngeal dysphagia, cricopharyngeal achalasia, in several neurosurgical conditions and on severely ill ventilated patients. I.v. premedication is not always necessary for transnasal oesophago-gastro-duodenoscopy done with ultrathin endoscopes.
Conclusions:
The oesophagus might be accessed also via the nose, but it must be emphasized that transnasal oesophago-gastro-duodenoscopy is only advised when the standard way of upper gastrointestinal tract endoscopy is impossible.