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Esophagoscopy is an endoscopic examination that involves viewing the inner walls of the esophagus with a special speculum. Thanks to esophagoscopy, it is possible not only to assess the condition of the esophagus, but also to perform some diagnostic procedures (e.g. taking a section of the esophagus wall for further examination if cancer is suspected) and therapeutic procedures (e.g. removing a foreign body). What is esophagoscopy? What are the indications for its implementation? What complications can it give?

Esophagoscopyinvolves viewing the inner walls of the esophagus using a rigid (esophagoscope) or flexible (gastrofiberoscope) endoscope (also known as a speculum). However, esophagoscopy is not only a test that allows you to assess the condition of the esophageal walls (it allows you to determine whether they are irritated, whether there are ulcers or inflammation within them). It also allows you to perform some diagnostic procedures (e.g. biopsy, i.e. excision of a fragment of esophageal tissue for further examination) and therapeutic procedures (e.g. removal of a foreign body). Therefore, the endoscope can be equipped with a suitable tool for taking samples or removing abnormal tissue.

Esophagoscopy - indications

Rigid endoscopy esophagoscopy is indicated in cases of suspected esophageal foreign matter, esophageal polyps, esophageal achalasia (and associated difficulty in swallowing) or, less commonly, esophageal varices. In addition, esophagoscopy is performed to diagnose changes in the walls of the esophagus after ingestion of corrosive substances (chemical burn of the esophagus). Esophagoscopy is also indicated when esophageal cancer is suspected. This type of esophageal endoscopy can also be used to collect a specimen of esophageal tissue for examination (biopsy).

In turn, esophagoscopy with a flexible endoscope is performed to remove a foreign body with a smooth surface (e.g. coins) in people who for some reason cannot undergo general anesthesia or endoscopy with a rigid speculum (e.g. stiff spine or pathological kyphosis) ). In addition, flexible endoscope esophagoscopy is usually performed on bleeding esophageal varices.

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Esophagoscopy - contraindications

Rigid speculum esophagoscopy should not be performed in people with serious changes in the cervical and / or thoracic spine and in those who cannot undergo general anesthesia, while the contraindication to perform esophagoscopy with a flexible speculum is the location of the lesions in the pericardial area or in the mouth of the esophagus. In addition, in people with Zenker diverticulum, this type of esophagoscopy should be performed with special caution (due to the risk of perforation of the esophagus).

Esophagoscopy - how to prepare?

You must not eat or drink anything for about 4 hours before the esophagoscopy.

Esophagoscopy - what is it?

  • Esophagoscopy using a rigid speculum

This type of esophagoscopy is performed under general anesthesia. The patient is lying on his back. He then lifts his head up and keeps it tilted back. Then the doctor opens the patient's throat with the spoon of the laryngoscope, inserts a metal speculum through the mouth (after passing the endoscope through the mouth of the esophagus, the patient's head is lowered) and moves it gently deeper until it is in the esophagus.

  • Esophagoscopy performed with a flexible speculum

Before the procedure, it may be necessary to perform an X-ray of the esophagus after oral administration of contrast.

This type of esophagoscopy is performed under local anesthesia - lidocaine is usually used to numb the esophagus. In addition, the patient may be given sedatives. Then the mouthpiece is attached to prevent it from clenching its teeth during the procedure.

The patient is lying on his left side with his head supported and slightly tilted forward. The doctor stands to the side of the patient and introduces a speculum into the mouth. The patient then takes a deep breath and performs the swallowing reflex, while the doctor, standing to one side, slides the speculum into the esophagus with his right hand.

It is worth knowing that the speculum can be moved to the stomach and duodenum, which means that endoscopy of the entire upper gastrointestinal tract can be performed simultaneously.

Esophagoscopy - complications after the procedure

After esophagoscopy with a rigid endoscope, it may lead to:

  • perforation (perforation) of the pharynx or esophagus, leading to mediastinitis, pleural, pericardial and peritoneal damage. It is worth knowing that in patients with previously undiagnosed Zenker diverticulum, the risk of perforation is significantly increased;
  • tooth damage or loss, especially in patients with previous tooth damage;
  • dislocation of the tincture cartilage (i.e.cartilage building the cartilage skeleton of the larynx);
  • infections;

In flexible speculum esophagoscopy, the risks are similar, but the risk of perforation of the esophageal wall is much lower (which does not mean that it is completely excluded).

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