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Gastrointestinal endoscopy in high-risk patients
1Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA.
Digestive Diseases (Basel, Switzerland)
|July 1, 1996
Summary
Gastrointestinal endoscopy is generally safe for high-risk patients, including those who are pregnant or have HIV. Procedures like esophagogastroduodenoscopy (EGD) and sigmoidoscopy are safe within 3 weeks of surgery or myocardial infarction in stable patients.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Patient Safety
Background:
- Gastrointestinal endoscopy is frequently performed on over 100,000 high-risk patients annually in the US.
- Assessing the safety and efficacy of these procedures in specific high-risk populations is crucial.
Purpose of the Study:
- To review the safety and efficacy of gastrointestinal endoscopy in high-risk patient groups.
- To evaluate endoscopic procedures in pregnant patients, those with recent myocardial infarction, advanced HIV infection, post-gastrointestinal surgery, and chronic obstructive pulmonary disease (COPD).
Main Methods:
- Review of existing studies, case-controlled studies, surveys, and case reports.
- Analysis of endoscopic procedures (esophagogastroduodenoscopy, sigmoidoscopy, colonoscopy) in various high-risk cohorts.
Main Results:
- Esophagogastroduodenoscopy (EGD) and sigmoidoscopy appear safe during pregnancy.
- Endoscopy is safe in stable patients with uncomplicated myocardial infarction or advanced HIV.
- EGD and sigmoidoscopy are generally safe within 3 weeks of gastrointestinal surgery.
- EGD is safe in COPD patients without severe hypoxemia or acute bronchospasm; emergency EGD is feasible with intubation.
Conclusions:
- Gastrointestinal endoscopy, particularly EGD and sigmoidoscopy, can be safely performed in most high-risk patients.
- Careful patient selection and monitoring are essential, especially in unstable patients or those with severe respiratory compromise.