Gastroenterology

Gastroscopy

In the Department of Gastroenterology; Patient comfort is prioritized for endoscopic examination and procedures. There are also endoscopy units which are prepared under ideal conditions where physicians and health personnel can work comfortably.


 

Endoscopy

Endoscopy is the examination of the internal organs of the stomach and similar hollow organs by direct visualization with advanced optical devices.
 

Esophagoscopy

It is an endoscopic examination method that provides visualization of the entire esophagus. The optic tube (endoscope) that enters the mouth is inserted into the sink and the area between the pharynx and the esophagus. Since the walls of the esophagus are adherent to each other, the area where the organ joins the stomach is carefully removed without damaging the tissue. In esophagoscopy, the condition of the mucosa, whether there is a tumor, foreign bodies and especially the congenital or later forms of dysfunction are examined. It should be noted that there may be significant changes in the diameter of the organ. Occasionally, vesicles (diverticula) are seen along the wall or the entire esophagus has expanded (mega-esophagus). However, constrictions or blockages may be observed. Small mucosa pieces taken with esophagoscopy are examined under a microscope. These particles are used to distinguish malignant formations such as tumors.
 

Gastroscopy

Upper gastrointestinal system (esophagus, stomach and duodenum) is the process of examination. This is done by an endoscopy instrument. The tool is in the form of a soft, plastic, pinky-finger, cable. It is a camera system that transmits the image of the paths to the television screen.
 

When is gastroscopy required?

Problems related to swallowing (painful swallowing, difficulty in swallowing solid or liquid foods, food dropping down, etc.)
Gastrointestinal pain and burns without medical treatment
Abdominal pain (chewy or sustained pain in the middle upper abdomen, open or a few hours after eating)
Red color or vomiting during vomiting
Vomiting with abdominal pain
Abnormalities in gastric graphy
 

Colonoscopy

It is a method of displaying all the large and small intestines adjacent to the large intestine by entering from the anus through a thin and bendable tube with a camera at the end. Examination of the portion of the large intestine near the anus is called sigmoidoscopy. Before the procedure, the intestines should be cleaned with the help of laxative. Colon (large intestine) is the most reliable method in the diagnosis of cancer. It also protects patients from cancer by detecting and removing pre-cancerous lesions like polyps and similar. In order to avoid colon cancer, it is recommended that the examination be performed to all people over 50 years old. Patients with colon cancer in their close relatives should undergo colonoscopy 10 years before the age of the youngest cancer patient in the family.

The majority of colon cancers develop over benign tumors called polyps. Colonoscopy at the appropriate time allows the polyps to be removed at the stage before cancer develops. In this way, patients are free of both cancer and surgery. Those receiving polyps from the large intestine should undergo follow-up colonoscopies every 1 to 3 years depending on the nature of the polyp. It is also used in the diagnosis and follow-up of non-cancerous bowel diseases such as colonoscopy, ulcerative colitis and Crohn's disease. Colonoscopy can prevent patients from surgery by providing diagnosis and treatment of large intestinal bleeding.
 

What is ERCP?

ERCP (Endoscopic retrograde cholangiopancreatography) is used in the diagnosis and treatment of biliary tract inflammation (cholangitis), pancreatic inflammation (pancreatitis), which may cause stenosis or obstruction in the biliary tract and pancreatic duct. Interference is made using a videomicoscopic device (Duodenoscope). The process is carried out in a period ranging from 20 minutes to an hour. Before the procedure, the patient is examined and the necessary tests are performed. The person to be ERCP should be hungry for at least 8 hours before the procedure. In addition, if the use of blood-diluting drugs such as Aspirin, Coumadin, they should be discontinued a week before the procedure.

ERCP procedure is performed by lying on the patient x-ray table in the left side position. Before the procedure, the patient is sprayed with a local anesthetic spray into his throat to allow the patient to swallow the endoscope comfortably. Thus, although the patient is in sleep state during the procedure, the consciousness is open and communication can be established if necessary. Sedation is performed by mouth with a side-view endoscope. The duodenoscope allows the passage of the duodenum to the second part of the intestine and the area where the bile ducts are opened to the intestine.

There is the main bile duct and papillae, where the pancreatic duct is opened to the intestine. A small cannula is injected through the small hole at the tip of the papilla to inject the contrast material into the pancreas and visualize the bile ducts. Some pathologies in the biliary tract or pancreas can be treated in the same session. In the presence of stones, sludge or stenosis in the bile ducts during the ERCP, the papillae is extended by cutting with a special tool passing through the duodenoscope. This process is called endoscopic sphincterotomy. This catheter is inserted into the mouth of the papillae, which is expanded and cut into the bowel stones and / or the gallbladder is poured into the intestine; they are then excreted through feces. Sometimes it is necessary to use mechanical stone crushers called lithotripter for large gallstones which may cause obstruction in the intestines.

Hemorrhage, puncture; Complications such as acute pancreatitis and cholangitis can be seen. The most common complication is bleeding with 2.5%. However, most bleeding stops spontaneously without intervention. Endoscopic intervention is possible in non-stop bleeding. Puncture and abscess development during this procedure is rare; it may be life-threatening if not diagnosed early.

Acute pancreatitis after ERCP is usually mild and responds well to medical treatment. If the patient is followed up for several hours after ERCP, he / she can be sent home with recommendations unless a complication develops. Rest is recommended in the rest of the day.