Practical Pediatric Gastrointestinal Endoscopy (eBook)

Dr George Gershman, Associate Professor of Pediatrics andChief of the Division of Pediatric Gastroenterology and Nutrition,Harbor-UCLA Medical Center, Los Angeles, USA. Dr Marvin Ament, Professor of Pediatrics and Chief of theDivision of Pediatric Gastroenterology, Hepatology and Nutrition,David Geffen School of Medicine at UCLA, Los Angeles, USA.

Practical Pediatric Gastrointestinal Endoscopy 1
Contents 7
Contributors 10
1 Introduction 11
2 Settings and Staff 12
The endoscopy unit 12
Pediatric endoscopy nurse 13
Disinfections of the endoscopes and accessories 14
Documentation 14
Further reading 15
3 Equipment 16
Overview 16
Insertion tube 16
Video image capture 26
“Reading’’ the image created on the CCD 28
Types of CCDs 30
History of endoscope CCD development 31
Shape of displayed image 32
Reproduction of color 33
Reproduction of motion 42
Transillumination 43
Laser therapy with video endoscopes 43
Image resolution 44
Color reproduction accuracy 45
Troubleshooting 45
Endoscope reprocessing 45
Summary 53
Further reading 53
4 Patient Preparation 55
Pediatric-monitored sedation and anesthesia for diagnostic and therapeutic procedures in endoscopy 56
During sedation 61
Postsedation care 62
Specific sedation techniques 62
Further reading 67
5 Diagnostic Upper Endoscopy Technique 70
Preparation for esophageal intubation 70
Assembling the equipment and preprocedure checkup 71
Endoscope handling 72
Technique of esophageal intubation 73
Indications for upper endoscopy 87
Push enteroscopy/jejunoscopy 104
Further reading 107
6 Therapeutic Upper GI Endoscopy 112
Benign esophageal stricture 112
Pneumatic dilation in achalasia 113
Foreign bodies 115
Endoscopic hemostasis 119
Percutaneous endoscopic gastrostomy 127
Nasojejunal tube placement 135
Further reading 137
7 Pediatric Colonoscopy 142
Introduction 142
Indications for colonoscopy 142
Preparation of the patient for colonoscopy 144
Equipment 147
Magnetic imaging system 148
Informed consent and preprocedure preparation 149
Sedation for colonoscopy 149
Embryology of the colon 150
Endoscopic anatomy 152
Torque-steering technique 157
Exploration of the sigmoid colon and sigmoid–descending junction 162
Splenic flexure and transverse colon 164
Hepatic flexure, ascending colon, and cecum 165
Terminal ileum 166
Complications 167
Common pathology 169
Further reading 178
8 Polypectomy 181
Basic principles of electrosurgery 181
Snare loops 183
Polypectomy routine 185
Safety routine 185
Safety conditions and techniques 186
Complications 190
Further reading 190
9 Chromoendoscopy 191
Indications 191
Application technique 194
Recognition of the lesions 199
Further reading 203
10 Wireless Capsule Endoscopy 204
History 204
The GIVEN M2A system 204
Localization 205
Suspected blood indicator 206
Indication for use 206
Diagnostic yield 206
Contraindications to capsule endoscopy 207
Pacemaker safety 207
Bowel preparation 207
Promotility agents 208
Endoscopic assistance 208
Complications 208
Outcome of capsule endoscopy 208
Pediatric patients 208
Further reading 209
Index 211

"Based on the experience of the authors, the book presents in 10chapters with many illustrations in color the equipment, proceduresand pathology of the gastro-intestinal tract in children. Each hasa reference list. For pediatric gastroentorologists" PediatricEndocrinology Reviews. December 2007

"The primary authors are well qualified in this field towrite such a book. I commend the authors for providing tables forequipment troubleshooting."
Practical Gastroenterology

"This is the only book presently available in the market whichdeals exclusively with paediatric endoscopy. The authors of thechapters are well established authorities in the field. They bringdiverse expertise to the work, including substantial experience inthe technology of endoscopic instruments and accessories, as wellas pathology, diagnostic methodologies and therapy of paediatricgatrointenstinal disease. The result is a book that is complete butat the same time easy to read and to understand.....Very nice book,complete, well written and apporpiately referenced, but at the sametime easy to understand. Its nice figures, tables and charts allowa quick and easy interpretation to the readers"- G. Manes.Digestive and Liver disease (40) 2008