| Gastrointestinal endoscopy in high-risk patients. | |
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MedLine Citation:
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PMID: 8843979 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In America more than 100,000 high-risk patients/year have conditions normally evaluated by gastrointestinal endoscopy. This review analyzes the safety and efficacy of gastrointestinal endoscopy in high-risk patients. Endoscopy during pregnancy raises the unique issue of fetal safety. The safety of esophagogastroduodenoscopy (EGD) during pregnancy has been examined in a case-controlled study of 83 patients, a mailed survey of 73 patients, and case reports. The safety of sigmoidoscopy during pregnancy has been examined in a case-controlled study of 45 patients, a mailed survey of 26 patients, and case reports. These studies suggest that EGD and sigmoidoscopy are not contraindicated during pregnancy. For example, EGD should be performed for significant upper gastrointestinal bleeding. The safety of colonoscopy during pregnancy is inadequately analyzed. In a study of 34 EGDs performed within 3 weeks of myocardial infarction, no endoscopic complications occurred in 26 clinically stable patients with uncomplicated myocardial infarction. However, 3 major endoscopic complications occurred in 8 clinically unstable patients. In a study of 9 sigmoidoscopies within 3 weeks of myocardial infarction, no sigmoidoscopic complications occurred in 7 clinically stable patients. Several studies have shown that EGD, sigmoidoscopy, or colonoscopy is safe in patients with advanced HIV infection. AIDS patients should generally be endoscoped with the same aggressiveness as other patients. However, endoscopy may be unwise in any terminal patient. No complication occurred in 60 patients undergoing EGD within 3 weeks of esophageal, gastric, or duodenal surgery. One minor complication occurred in 36 patients undergoing sigmoidoscopy within 3 weeks of colonic surgery. These results suggest that EGD or sigmoidoscopy is not contraindicated within 3 weeks of gastrointestinal surgery. No complications occurred in 53 chronic obstructive pulmonary disease patients undergoing EGD. EGD appears to be safe in chronic obstructive pulmonary disease patients without severe hypoxemia or acute bronchospasm. Emergency EGD can be performed in patients with severe hypoxemia after endotracheal intubation. |
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Authors:
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M S Cappell |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Digestive diseases (Basel, Switzerland) Volume: 14 ISSN: 0257-2753 ISO Abbreviation: Dig Dis Publication Date: 1996 Jul-Aug |
Date Detail:
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Created Date: 1996-10-29 Completed Date: 1996-10-29 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 8701186 Medline TA: Dig Dis Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 228-44 Citation Subset: IM; X |
Affiliation:
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Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Digestive System Surgical Procedures Endoscopy, Digestive System / adverse effects*, contraindications*, standards Female HIV Seropositivity / complications* Humans Lung Diseases, Obstructive / complications* Myocardial Infarction / complications* Postoperative Complications / etiology* Pregnancy Pregnancy Complications / etiology* Risk Factors Safety |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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