Clinical value of gastrointestinal fiberoptic endoscopy

This review describes the contribution of fiberoptic endoscopy and its associated ancillary procedures to the improved diagnosis of some common gastrointestinal disorders. The diagnostic approach to esophagitis and carcinoma of the esophagus and stomach is outlined. Swallowed foreign bodies that do not pass out of the stomach can be removed with relative ease by endoscopic ancillary procedures. The role of endoscopy in duodenal ulcer disease and the effects on morbidity and mortality of the vigorous diagnostic approach in upper gastrointestinal hemorrhage are discussed. Endoscopy is invaluable for assessing the condition of the stomach postoperatively. Colonoscopic polypectomy has lent support to the "poly-cancer" hypothesis. The role of colonoscopy in the evaluation of inflammatory bowel disease must still be delineated. Endoscopic retrograde cholangiopancreatography is of value in the investigation of obstructive jaundice and pancreatic disease. In the former, noninvasive techniques of ultrasonography and computerized tomography scanning complemented by fine-needle transhepatic cholangiography will probably be the preferred methods of investigation. The impact of the contribution of fiberoptic endoscopy on health care will be maintained only if the physician has been properly trained in its use and has an understanding of the different diseases.