Document Detail


Gastrointestinal endoscopy in high-risk patients.
MedLine Citation:
PMID:  8843979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M S Cappell
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Digestive diseases (Basel, Switzerland)     Volume:  14     ISSN:  0257-2753     ISO Abbreviation:  Dig Dis     Publication Date:    1996 Jul-Aug
Date Detail:
Created Date:  1996-10-29     Completed Date:  1996-10-29     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8701186     Medline TA:  Dig Dis     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  228-44     Citation Subset:  IM; X    
Affiliation:
Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA.
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MeSH Terms
Descriptor/Qualifier:
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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