Esophagoscopy

Esophagoscopy is an examination of the esophagus with bronchoesophagology. Produced for the purpose of diagnosis and treatment procedures in foreign bodies (diagnosis and removal)of the tumor (biopsy), burns and Scarring narrowing (bairovna), esophageal diverticula. The endoscopy is performed under local anesthesia or General anesthesia. Training Toolkit - see Bronchoesophagology. After ezofagoskopia appoint a light diet, in some cases when the injury of the esophagus or suspected her of parenteral nutrition, antibiotics.

Esophagoscopy in adults and small children can be performed under local anesthesia or with the use of anesthesia.
The position of the patient when ezofagoskopia. The esophagoscopy can be made at different positions of the patient: a) in a sitting position and with the torso forward;
b) in a horizontal position, on the side, back and abdomen;
C) in the knee-elbow position.
The technique of ezofagoskopia. The patient sits on a low bench or laid on his stomach so that the head and shoulders of freely hanging down. His tongue kept cloth as at laryngoscopy. Sterile ezofagoskopia tube smeared sterile vaseline oil. Esophagoscope is held with the right hand of the doctor, the index finger of the left hand which removes the upper lip patient up. The initial position of the tube on the middle line of the oral cavity. The tube handle raise up to see the epiglottis, which is then complete and the end of the tube is placed between harpaloides cartilage and rear of the throat; release the language of the patient; giving harpaloides cartilage forward while sliding the tube into the depth of the esophagus. The end of the tube down to the foreign body. Esophagoscopy at this time is fixed by the left hand of the doctor and the right he enters the tongs, which are still in the tube. The plane's feet tongs is installed in the best position to capture a foreign body. Paws forceps are on the sides of a foreign body. Foreign body is captured, tongs are fixed and together with the tube under visual control is retrieved from the esophagus (Fig. 15, 16).

Esophagoscopy (from the Greek. oisophagos - esophagus and skopeo - examine, investigate) - examination of the esophagus using a metal tube with electric lights (see Bronchoesophagology).
Their purpose esophagoscopy can be diagnostic and therapeutic (removal of foreign bodies, introduction of medicinal substances, a biopsy and other). Esophagoscopy shown in inaccurate recognized disease of the esophagus, foreign bodies, sudden obstruction of unknown etiology, Scarring.
Esophagoscopy can be done patient is in sitting position with head thrown back or lying on your back, stomach, on the right or left side, or in the knee-elbow position. In children under 5 years esophagoscopy done usually without anesthesia or General anesthesia. In adults, the use of local anesthesia in the form of lubrication or irrigation mucous membrane of the tongue, the back of the throat, hypopharynx and entry into the esophagus 5-10% a solution of cocaine or 1-3% solution dikaina. In addition, for 30-40 minutes before the manipulation of the patient is injected subcutaneously to 1 ml of 2% solution of morphine or 1 ml of 0.1% solution of atropine to reduce salivation and relieve spasm of the esophagus. Sometimes resort to General anesthesia (especially in patients easily excitable, with unbalanced type of nervous system).
It is most convenient to perform endoscopy in a sitting position (Fig. 1). Pre-lubricated tube esophagoscope vaseline oil for better sliding her injected into the cavity of the mouth and on the middle line of the language brought the end of the tube to the tab, then the direction of esophagoscope dramatically change. Right angle tube sent down; carefully bypass the root of the tongue, epiglottis, harpaloides cartilage and come to the entrance of the esophagus. The most difficult and crucial moment of ezofagoskopia - passing through the first physiological narrowing ("mouth" of the esophagus), which has the appearance of a gap (Fig. 2), slightly curved backwards. In this place there are often gaps of the esophagus. When conducting tube through this Department should give it a light rotational motion, pushing the most malleable front wall of the esophagus several front. Further study of the esophagus to pass through the aperture does not present much difficulty if the esophagus is not biased in one direction or another. When passing through the aperture should tilt the body of the patient to the front. The oesophageal mucosa healthy man a pale pink color, clearly visible longitudinal folds. Cardial section of the stomach looks pale pink star-shaped sockets (Fig. 3). With each breath the esophageal lumen thoracic expanding, and when exhaling narrowed. Pull the tube out of the esophagus slowly, all the while examining in detail the condition of the mucous membrane of the esophagus; it should be considered that the wounds of the past or rupture can lead to the development of mediastinitis. Trauma to the area harpalini cartilage or their joints can cause impaired mobility of the larynx.
There are methods of so-called retrograde ezofagoskopia, in which a tube of esophagoscope enter in a gastrostomy tube. During manipulation doctor is obliged at all times to ensure that the tube is moved accordingly to the axis of the esophagus with well visible light. Incorrect position of the handset, poor visibility of the lumen and the walls of the esophagus fix the direction of the tube should be no pressure on her wall of the esophagus, but mainly by changing the position of the head and body of the patient. A major obstacle when ezofagoskopia is filling the esophageal lumen and tube esophagoscope saliva, mucus, remnants of food, blood, by contrast agent, stomach contents. Delete them special long probes threaded on one end that wind wool, or by sucking.

Fig. 1. Esophagoscopy in a sitting position.
Fig. 2. "Mouth" of the esophagus (appearance when ezofagoskopia).
Fig. 3. Cardia OK (if ezofagoskopia).