Gastroenterological endoscopy:
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| Format: | Book |
| Language: | English |
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Stuttgart ; New York, NY
Thieme
[2010]
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| Edition: | Second edition |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Item Description: | Literaturangaben |
| Physical Description: | XXVII, 824 Seiten Illustrationen, Diagramme 31 cm |
| ISBN: | 9783131258526 |
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| 245 | 1 | 0 | |a Gastroenterological endoscopy |c Meinhard Classen, Guido N.J. Tytgat, Charles J. Lightdale ; Associate editors Jacques J. G. J. M. Bergman [und vier weitere] ; with contributions by Douglas G. Adler [und viele weitere] |
| 250 | |a Second edition | ||
| 264 | 1 | |a Stuttgart ; New York, NY |b Thieme |c [2010] | |
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| adam_text | Contents I Development of Endoscopy Section editors: Meinhard Classen, Guido N.j. Tytgat, Charles ]. Lightdale 1 Two Centuries of Digestive Tract Endoscopy: a Concise Report................................................................. 2 Meinhard Classen 2 Introduction......................................................................... Nineteenth-Century Pioneers............................................. Rudolf Schindler and the “Semiflexible” Endoscope......... Fiberglass Endoscopy and Electronic Endoscopy............... Japanese Contributions to Digestive Tract Endoscopy.... Colonoscopy......................................................................... Endoscopic Retrograde Cholangiopancreatography......... Percutaneous Transhepatic Cholangiography.................. Enteroscopy......................................................................... Therapeutic Endoscopy...................................................... Endoscopic Ultrasonography............................................. Laparoscopy......................................................................... Summary and Prospects..................................................... References............................................................................ 12 Quality Assurance.............................................................. 15 2 2 3 4 4 6 6 6 8 8 10 11 11 Anthony T. R. Axon Introduction......................................................................... History of Quality Assurance............................................. Quality Assurance in
Endoscopy........................................ Quality Indicators............................................................ Preprocedural Quality Indicators.................................... Intraprocedural Quality Indicators................................. Postprocedural Quality Indicators................................... Nursing Involvement in Quality Assurance............................................................................ How Should Quality Indicators Be Recorded?.................. Quality Assurance and Information Technology............... How Should Quality Assurance Data Be Used?............. The Endoscopy Global Rating Scale.................................... Impact of Quality Assurance on Endoscopic Practice....... What Are the Next Steps?................................................... Managing the Endoscopy Unit............................................ References............................................................................ 3 Advanced Imaging in Endoscopy.................................... 15 15 16 16 16 17 17 18 18 18 19 19 20 20 20 20 21 Ralf Kiesslich and Hisao Tajiri Introduction......................................................................... High-Resolution and Magnifying Endoscopy.................... Chromoendoscopy.............................................................. Digital Chromoendoscopy................................................... Functional Imaging.............................................................. Point
Spectroscopy.............................................................. Fluorescence Spectroscopy................................................. Elastic Scattering Spectroscopy.......................................... 21 21 21 22 24 24 24 24 Raman Spectroscopy............................................................ Multimodal Spectroscopy................................................... Autofluorescence Imaging................................................... Optical Coherence Tomography.......................................... Endocytoscopy..................................................................... Confocal Laser Endomicroscopy.......................................... Principle of Confocal Microscopy................................... Endoscopic Confocal Microscopy..................................... Contrast Agents................................................................ Clinical Data in Endomicroscopy........................................ Barrett’s Esophagus.......................................................... Gastritis and Gastric Cancer............................................ Celiac Disease.................................................................... Colorectal Cancer.............................................................. Ulcerative Colitis.............................................................. Microscopic Colitis.......................................................... Future of Endomicroscopy..............................................
Conclusions....................................................................... References............................................................................. 24 24 24 25 26 27 27 27 27 28 28 29 30 31 32 32 32 32 34 4 Evidence-Based Endoscopy................................................ 37 John M. Inadomi and Ma Somsouk Background........................................................................... Studies of Therapy................................................................ Clinical Scenario................................................................ Are the Results Valid?..................................................... What Are the Results?..................................................... Will the Results Help Me in Caring for My Patients? ... Resolution of the Clinical Scenario................................. Studies of Diagnosis............................................................ Clinical Scenario................................................................ Are the Results Valid?..................................................... What Are the Results?..................................................... Will the Results Help Me in Caring for My Patients?... Resolution of the Clinical Scenario................................. Studies of Harm.................................................................... Clinical Scenario................................................................ Are the Results Valid?..................................................... What Are the
Results?..................................................... Will the Results Help Me in Caring for My Patients? ... Resolution of the Clinical Scenario................................. How to Use an Article about Prognosis............................. Clinical Scenario................................................................ Are the Results Valid?..................................................... What Are the Results?..................................................... Will the Results Help Me in Caring for My Patients? ... Resolution of the Clinical Scenario................................. Conclusions........................................................................... References............................................................................. 37 37 37 37 38 39 39 39 39 39 40 41 41 42 42 42 42 43 43 43 43 43 44 44 45 45 45 ХШ
Contents II The Patient and Endoscopy Section editors: Cuido N.j. Tytgat, Meinhard Classen, Charles ]. Lightdale 5 Informed Consent for Gastrointestinal Endoscopy.... 48 Spiros D. Ladas 6 Endoscopy in Special Clinical Situations................ 67 Douglas C. Adler and David Björkman Historical Perspectives..................................................... The Concept of Informed Consent................................... Declarations Protecting Patients’ Rights.......................... Informed Consent for Gastrointestinal Endoscopy......... Exceptions to Informed Consent................................. Additional Issues on Informed Consent....................... Medicolegal Issues............................................................ Breach of Duty.............................................................. Malpractice in Gastrointestinal Endoscopy.................. Causes of Malpractice Claims in Endoscopy................ How and When Informed Consent Should be Obtained . Additional Issues on Obtaining Informed Consent......... Personnel Responsible for Obtaining Informed Consent Open-Access Gastrointestinal Endoscopy................... Obtaining Informed Consent for Teaching and Learning Endoscopy....................................................... Obtaining Informed Consent for Endoscopy-Based Research........................................................................ Obtaining Informed Consent for Live Endoscopy Demonstrations............................................................ Informed Consent and Endoscopy by Nonphysicians..
References........................................................................ 48 48 48 49 49 49 50 50 50 51 51 52 52 52 Patient Preparation and Sedation for Endoscopy........ 57 Introduction.............................................................. Endoscopy in Pregnant and Lactating Women........ Endoscopy in Pregnant Patients........................... Endoscopy in Lactating Patients........................... Endoscopy in the Elderly......................................... Endoscopy in Patients Requiring Anticoagulation or Antiplatelet Medications......................................... Management of Antiplatelet Agents.................... Management of Warfarin and Heparins............... Endoscopy in Patients with Hemophilia............ Restarting Anticoagulation...................................... Conclusion....................................................... References............................................................... 8 The Endoscopy Suite................................................. 52 53 53 53 54 Jenifer R. Lightdale Levels of Sedation............................................................. Patient Preparation and Assessment for Sedation........... Fasting Instructions...................................................... Patient Medical History and Examination................... Airway Evaluation........................................................ Special Patient Considerations..................................... Procedures without Sedation.......................................... Pharmacological Options for
Endoscopy........................ Topical Agents................................................................... Benzodiazepines............................................................... Diazepam...................................................................... Midazolam..................................................................... Opioids.............................................................................. Pethidine (Meperidine)................................................. Fentanyl........................................................................ Adjuvant Agents............................................................... Propofol............................................................................ Antagonists...................................................................... Flumazenil..................................................................... Naloxone...................................................................... Care and Monitoring of the Patient during Endoscopy... Electronic Monitoring and Intervention....................... References........................................................................ 7 57 58 58 58 59 60 60 60 61 61 61 61 62 62 62 62 62 63 63 63 63 63 64 67 67 ■57 58 69 71 72 72 72 75 Hans-Dieter Allescher General Questions and Considerations................. . Guidelines for Planning an Endoscopy Suite........... Pathways for Patients, Staff and Materials............. Location of the Unit............................................ Number of
Rooms................................................... Radiographic Requirements........................ . The Endoscopic Examination Room...................... Size of the Rooms............................................. Equipment.......................................................... Monitor Systems and Anesthesia........................ Video Integration and Computer-Based Documentation................................................... Endoscopes and Endoscopic Equipment............ Endoscopic Ultrasound and Laser Treatment Roer;; Radiography Room................................................ Preparation and Recovery Room........................... Cleaning and Disinfection Area............................... Staffing................................................................. References..................................................... 75 75 75 76 77 78 78 78 78 79 9 Cleaning and Disinfection in Endoscopy............. 83 79 79 80 30 80 30 80 Michael Jung and Thierry Ponchon Spaulding Criteria.............................................. Mechanisms of Infection in Endoscopy................. Indicator Bacteria................................................... Infections in Endoscopy......................................... Guidelines.............................................................. Reprocessing of Endoscopic Accessories............... New Agents and Disinfectants............................... Quality Assurance in Endoscope Reprocessing....... Infections Occurring in Endoscopy (Outbreak Management).......................................
Conclusions............................................................ References.............................................................. 83 83 84 84 85 86 86 87 88 88 88
Contents III Teaching and Learning Section editors: Meinhard Classen, Guido N.j. Tytgat, Charles ]. Lightdale 10 Education and Training.................................................. 92 Juergen Hochberger, Juergen Maiss, Kai Matthes, Guido Costamagna, and Robert H. Hawes Introduction....................................................................... Clinical Education.............................................................. Clinical Training in EGD and Colonoscopy: Studies and Guidelines................................................... Studies and Guidelines on Clinical Training in ERCP ... Practical Training in ERCP.............................................. Complementary Video Courses..................................... Current Training Models................................................... Plastic Phantoms and OtherStatic Models..................... Computer Simulators..................................................... 92 92 92 93 93 94 94 94 95 Training Courses with Live Animals.............................. Ex Vivo Porcine Tissue Models (EASIE, Erlanger Endo-Trainer, EASIE-R)................................................... Training Courses................................................................ Comparison of Teaching Models for Training Courses.... Acquiring Teaching Skills as a Tutor.................................. Open Questions and Future Prospects.............................. Maintaining Skills in Complex Procedures.................... Incorporating Simulator Training into Educational
Programs......................................................................... Training in NOTES and the Future Endoscopic Interventionalist............................................................ References........................................................................... 96 98 100 101 102 102 102 102 102 102 IV Diagnostic Procedures and Techniques Section editors: Meinhard Classen, Guido N.j. Tytgat, Michael B. Wallace 11 Upper Gastrointestinal Endoscopy.................................. 106 Michel Delvaux and Gerard Gay Technical Description of the Gastroscope......................... Description of the Procedure............................................ Sedation.......................................................................... Preparation of the Patient.............................................. Insertion of the Endoscope............................................ Advancement of the Endoscope and Maneuvering for a Complete Examination........................................... After the Procedure......................................................... Normal Endoscopic Anatomy of the Upper Gastrointestinal Tract......................................................... Esophagus....................................................................... Stomach.......................................................................... Duodenum..................................................................... Anatomical Variants.......................................................... Surgically Modified
Anatomy......................................... Difficult-to-Examine Anatomical Locations..................... Indications and Contraindications..................................... Indications....................................................................... Contraindications.......................................................... Appropriateness of Indications..................................... Complications..................................................................... Documentation of an EGD Procedure................................ Conclusion.......................................................................... References.......................................................................... 106 106 106 107 107 12 Enteroscopy Techniques.................................................. 119 Potential Indications for VCE......................................... Interplay between VCE and Deep Enteroscopy................ Summary............................................................................ References........................................................................... 131 131 132 132 14 Colonoscopy: Basic Instrumentation and Technique... 133 Brian Saunders Introduction....................................................................... Balloon-Assisted Enteroscopy........................................... Intraoperative Enteroscopy................................................ References.......................................................................... 119 119 123 124
Introduction....................................................................... Indications........................................................................... Contraindications.............................................................. Bowel Preparation.............................................................. Instructions for Morning and Afternoon Appointments Sedation.............................................................................. Antispasmodics.............................................................. Equipment for Colonoscopy.............................................. Carbon Dioxide Versus Air Insufflation......................... Accessories..................................................................... Imaging during Colonoscopy............................................ Fluoroscopy..................................................................... Magnetic Endoscope Imaging......................................... Colonoscope Insertion: Technique.................................... General Principles........................................................... Instrument Handling..................................................... Ancillary Techniques for Colonoscope Insertion........... Anus and Rectum............................................................ Sigmoid Colon................................................................ Descending Colon and Splenic Flexure......................... Transverse Colon and Hepatic Flexure........................... Ascending Colon, Cecum, and Terminal Ileum..............
Is Total Colonoscopy Achievable in All Patients?........... Examination Technique during Withdrawal..................... Complications..................................................................... References........................................................................... 13 Wireless Video Capsule Endoscopy................................ 127 15 ERCP................................................................................... 108 109 109 109 110 Ill Ill 112 114 114 114 114 114 115 115 116 116 Blair S. Lewis and Kiyonori Kobayashi David Cave Introduction....................................................................... Technology........................................................................ Limitations........................................................................ Complications..................................................................... Indications and Contraindications..................................... 127 127 128 129 129 133 133 134 134 135 135 136 136 138 139 139 139 140 141 141 141 142 142 143 145 146 147 148 148 148 149 151 Gregory B. Haber, Curpal S. Sandha, and Meinhard Classen Historical Background Indications.................. Facilities..................... Equipment.................. Endoscopes............ 151 151 151 152 152
Contents Cannulating Devices........................................................ Contrast Agents................................................................ Technique............................................................................... Patient Preparation and Sedation.................................. Procedure............................................................................... Oropharyngeal Intubation............................................... Cannulating the Minor Papilla....................................... Challenging Scenarios...................................................... Complications....................................................................... Pancreatitis....................................................................... Future Directions................................................................. References............................................................................. 152 153 153 153 154 154 154 157 157 158 158 159 16 Peroral Cholangioscopy.................................................... Axel Eickhoff and Juergen F. Riemann Introduction........................................................................... Procedure............................................................................... Instruments and Technique............................................. New Intraductal Endoscopy Techniques........................ Complications....................................................................... Clinical
Applications............................................................ Diagnostic Peroral Cholangioscopy................................ Therapeutic Peroral Cholangioscopy.............................. Conclusions........................................................................... References............................................................................. 160 17 Percutaneous Transhepatic Cholangiography and Cholangioscopy............................................................ Jean-Pierre Charton, Chan Sup Shim, and Horst Neuhaus Introduction........................................................................... Indications............................................................................. Contraindications................................................................. Equipment............................................................................. Cholangioscopes............................................................... Lithotriptors..................................................................... Patient Preparation.............................................................. Procedures............................................................................. Percutaneous Transhepatic Cholangiography............... Percutaneous Transhepatic Cholangiographie Drainage............................................................................. Percutaneous Transhepatic Cholangioplasty, Biliary Stent Placement, and Photodynamic Therapy.. Percutaneous Transhepatic Cholangioscopy................. Percutaneous Stone
Removal......................................... Postprocedural Care of the Transhepatic Tract................. Results..................................................................................... PTC, PTCD, Cholangioplasty, and Stent Placement....... Diagnostic Percutaneous Transhepatic Cholangioscopy.. Therapeutic Percutaneous Transhepatic Cholangioscopy Complications and Management....................................... Conclusions........................................................................... References............................................................................. XVI І 160 160 160 160 163 163 163 164 165 165 Endoscopic Findings and Therapy in the Early Postoperative Period....................................................... Endoscopic Findings and Therapy in the Late Postoperative Period and Follow-Up............................. Endoscopic Therapeutic Interventions............................. Stomal Stenosis and Stoma/Outlet Obstruction........... Dilated Gastrojejunostomy after Gastric Bypass Surgery........................................................................... Staple-Line Dehiscence and Gastrogastric Fistula in VBG and RYGB............................................................ Band Erosion............................................................ Endoscopic Access to the Bypassed Stomach and Duodenum and to the Papilla of Vater in RYGB .. Conclusions.................................................................. References.................................................................... 19 Magnifying
Chromocolonoscopy and Tattooing Shin-ei Kudo, Hideyuki Miyachi, and Shungo Endo Introduction........................................................ Practical Aspects of Diagnosis Based on Magnifying Endoscopy............................................................ Recent Trends in Endoscopic Diagnosis of the Ty pe V Pit Pattern............................................................ Treatment Policies Based on Morphological Development and Pit Patterns..................... Endoscopic Tattooing Technique.................... References.................................................................... 186 187 187 188 190 190 191 192 193 193 197 197 197 199 200 201 202 167 167 167 167 167 168 168 168 168 168 168 169 170 171 171 173 173 174 174 175 176 176 18 Endoscopic Therapy in Obesity....................................... Elisabeth M.H. Mathus-Vliegen 179 Introduction........................................................................... Endoscopic Treatments for Obesity................................... Intragastric Balloon Treatment....................................... Other Endoscopic Modalities........................................... Endoscopic Treatment for Bariatric Surgery Complications....................................................................... Surgical Procedures.......................................................... Role of Endoscopy............................................................ Normal Endoscopic Findings........................................... Reported
Complications................................................... 179 179 179 182 182 182 184 184 185 20 Tissue and Fluid Sampling.................................... Koji Matsuda and Hisao Tajin Introduction................................................................... Devices....................................................................... Biopsy Forceps................................................... Polypectomy Snare................................................. Brush Cytology.............................................................. Fine-Needle Aspiration Cytology.................... . EGD..................................................................... . ■ · Esophagus................................................................ Stomach.................................................................... Duodenum.......................................................... Enteroscopy............................................................ · Colonoscopy............................................................ ERCP.............................................................................. EUS-FNA........................ Sampling of Body Fluids Summary...................... References.................... 203 21 The Contribution of Histopathology to Endoscopy— Karel Geboes Introduction......................................................................... Endoscopy and the Diagnostic Yield of Histopathology.. --------------- Г J — u Jmmunohisiochemistry and Other Ancillary Techniques. Role of Pathology in the
Esophagus.................................. Inflammatory Conditions............................................... Neoplastic Conditions..................................................... Role of Pathology in the Stomach.................................... Inflammatory Conditions............................................... Neoplastic Conditions..................................................... Role of Pathology in the Duodenum................................. Inflammatory Conditions............................................... Neoplastic Conditions..................................................... Role of Pathology in the Terminal Ileum and Colon...... inflammatory Conditions............................................... Neoplastic Conditions..................................................... 211 203 203 203 203 203 203 206 -06 206 206 206 206 206 211 2П 212 213 213 214 215 215 217 217 217 219 219 219 221
Contents Conclusions........................................................................... References............................................................................. 222 222 22 Diagnostic Endoscopic Ultrasonography........................ Abdel M. Kassem, Thomas Rösch Introduction.......................................................................... Available Instruments and Scanning Principles................. Basics of EUS-Guided Puncture Techniques...................... Clinical Background and Prerequisites of EUS and EUS-Guided Fine-Needle Puncture..................................... Examination Technique and Normal Findings................... Preparation, Sedation, and Complications...................... Upper Gastrointestinal Tract............................................ Mediastinum.................................................................... Pancreas and Biliary Tract................................................ Colorectum........................................................................ Pathological Findings: General Principles.......................... Tumor Staging in the Gastrointestinal Tract................... Submucosal Lesions......................................................... Tumor Diagnosis and Staging in the Pancreaticobiliary Tract.................................................... Benign Lesions and Differential Diagnosis.................... Fine-Needle Puncture: Accuracy, Pitfalls, and Limitations........................................................................ Further
Developments......................................................... Training in EUS...................................................................... References............................................................................. 225 23 Laparoscopic, Natural Orifice, and LaparoscopyAssisted Surgery: New Paradigms in Minimally Invasive Therapy................................................................. Robert H. Hawes, Stefan von Delius, D. Nageshwar Reddy, and Hubertus Feußner Introduction.......................................................................... Robert H. Hawes Laparoscopic Cholecystotomy............................................ Stefan von Delius Patient Selection............................................................... Technique.......................................................................... Effectiveness of LCT........................................................... 225 225 227 229 230 230 230 231 231 233 233 233 235 236 238 240 240 241 241 245 245 246 246 246 248 Percutaneous Cholecystostomy....................................... Endoscopic Gallbladder Drainage................................... Natural Orifice Transluminal Endoscopic Surgery............. D. Nageshwar Reddy Introduction...................................................................... Transgastric Appendectomy............................................. Transgastric Tubal Occlusion........................................... Transvaginal Cholecystectomy......................................... Other Access
Routes......................................................... Benefits and Pitfalls........................................................... Conclusion.......................................................................... Combined Laparoscopic and Endoscopic Interventions and Transcolonic/Transgastric NOTES Procedures........... Hubertus Feußner Introduction...................................................................... Indications.......................................................................... Contraindications............................................................. General Principles............................................................. General Technical Aspects................................................ LEP Variants...................................................................... Results of Laparoscopic-Endoscopic Procedures........... Laparoscopic-Endoscopic Procedures as “Pseudo-NOTES”............................................................... References.............................................................................. 248 248 248 248 249 250 250 251 253 253 253 253 254 254 254 254 255 256 257 257 24 Liver Biopsy......................................................................... 261 Andrew K. Burroughs, Marco Senzolo, and Evangelos Cholongitas Introduction.......................................................................... Indications.............................................................................. Percutaneous Liver Biopsy.................................................. Menghini
Technique......................................................... Tru-Cut Needle Biopsy...................................................... Plugged Percutaneous Liver Biopsy................................ Fine-Needle Aspiration Biopsy of the Liver..................... Ultrasound-Guided Liver Biopsy..................................... Transvenous (Jugular) Approach......................................... Quality of Liver Biopsies for Accurate Histológica! Interpretation........................................................................ Laparoscopic Biopsy of the Liver......................................... References.............................................................................. 261 261 261 262 262 264 264 265 265 267 268 268 Tissue Adhesives................................................................... Endoloops and Detachable Mini-Snares........................ References.............................................................................. 278 278 279 26 Laser Application............................................................... Hugh Barr Physics and Principles of Laser Therapy............................ Interaction of Laser Light with Tissue.............................. Types of Lasers...................................................................... Endoscopic Laser Therapy.................................................... Hemostasis........................................................................ Palliation of Malignant Dysphagia................................... Ampullary and Duodenal
Neoplasia................................ Colorectal Cancer............................................................... Early Gastrointestinal Cancer and Precancer................. Biliary Tract........................................................................ Conclusions............................................................................ References.............................................................................. 281 V Therapeutic Procedures Section editors: Cuido N.j. Tytgat, Meinhard Classen, and Charles 1. Lightdale 25 Hemostasis.......................................................................... Sandy H.Y. Pang and James У.ѴѴ. Lau Overview............................................................................... Nonvariceal Hemorrhage..................................................... Injection Therapy............................................................... Thermal Methods............................................................. Hemoclips.......................................................................... Heater Probe vs. Hemoclips............................................ Monotherapy versus Combination Treatment............... Endoscopic Signs of Bleeding.......................................... Limitations of Endoscopic Therapy................................. Other Nonvariceal Bleeding Sources................................ Variceal Hemorrhage........................................................... Endoscopic Variceal Ligation.......................................... Endoscopic Injection
Sclerotherapy............................... Band Ligation versus Endoscopic Injection Sclerotherapy.................................................................... Combining Banding Ligation and Sclerotherapy........... 272 272 272 272 273 274 275 275 275 276 276 276 276 277 277 278 281 281 281 282 282 282 283 283 283 286 286 286 XVII
Contents 27 Argon Plasma Coagulation.............................................. James A. DiSario 287 Technology............................................................................ Tissue Effects........................................................................ Clinical Techniques............................................................. Clinical Applications and Outcomes................................. Tissue Ablation................................................................. Hemostasis......................................................................... Zenker’s Diverticulum...................................................... Stent Manipulation.......................................................... References............................................................................ 287 287 288 289 289 293 295 295 296 29 Polypectomy....................................................................... 299 Jerome D. Waye, Brian Saunders, Yasushi Sano, and Shinji Tanaka Principles of Colonoscopic Polypectomy.......................... 299 Heat Sealing of Blood Vessels......................................... 299 Type of Current................................................................. 299 Electrosurgical Unit.......................................................... 299 Coaptive Coagulation...................................................... 299 Types of Polyp....................................................................... 299 Chromoendoscopy............................................................... 300 Narrow-Band
Imaging.......................................................... 300 Endoscopic Accessories........................................................ 302 Electrosurgical Units........................................................ 302 Injector Needles............................................................... 303 Colonoscope..................................................................... 303 Carbon Dioxide................................................................. 303 Hot Biopsy Forceps.......................................................... 303 Heater Probe and BICAP.................................................. 303 Argon Plasma Coagulator................................................ 303 Detachable Loop............................................................... 303 Clips.................................................................................... 304 305 Snares................................................................................ Prepolypectomy Laboratory Testing.............................. 305 Aspirin and Anticoagulants............................................. 305 305 Polypectomy Technique...................................................... 305 Polyp Position................................................................... 305 Small Polyps..................................................................... 305 Snare Catheter Placement.............................................. 306 Pedunculated Polyps........................................................ 306 Sessile
Polyps................................................................... Endoscopic Mucosal Resection (EMR) and Submucosal 306 Dissection (ESD)............................................................... 306 Treatment of the Polyp Base after Removal................... 308 Methods for Safer Polypectomy......................................... 308 Marking the Snare Handle.............................................. 309 Submucosal Injection for Polypectomy........................ Volume of Injected Fluid................................................. 309 310 Malignant Polyps.............................................................. 311 Tumor Tracking................................................................ 311 Air Aspiration................................................................... 311 The Tip of the Snare.......................................................... 311 Stopping at the Line.......................................................... 311 Tent the Polyp away from the Base................................ 311 Piecemeal Polypectomy.................................................. 312 Problems.............................................................................. 312 Polyp Position................................................................... 313 When to Remove Polyps................................................. 313 Positional Changes and Abdominal Pressure............... 313 Rotatable Snares................................................................ 313 Mini-
Snares....................................................................... 313 Gastroscope for Better Tip Deflection............................ 313 New Colonoscopes............................................................ 313 The Third-Eye Retroscope............................................... 314 Clamshell Polyps.............................................................. Retroversion.............................................................. Follow-Up Interval..................................................... Polyp Size.................................................................... Bleeding during Polypectomy................................... Polyps Too Difficult to Remove.................................... Flat Polyps.................................................................. Extremely Difficult Colonoscopy............................. Location of Lesions......................................................... Endoscopic Follow-Up.............................................. Healing of Polypectomy Site.................................... Invalidity of Shaft Measurement......................... Endoscopic Landmarks.......................................... . Clips............................................................................ Intraoperative Colonoscopy...................................... Marker Injections into the Colon Wall................ . Complications.......................................................... Perforation..................................................... ......... Postpolypectomy Coagulation Syndrome
(Sērosi. Transmurai Burn, Postpolypectomy Syndrome),. Postpolypectomy Hemorrhage................................. Hot Biopsy Forceps.......................................... . Results......................................................................... Checklist of Practice Points........................................ References................................................................. 29 Dilation Techniques..................................................... Shabana F. Pasha and David E. Fleischer Introduction.................................................................. Predilation Evaluation................................................... Indications and Contraindications.................... . Preparation.............................................................. Types of Dilator........................................................ Physiology of Esophageal Dilation............................. Dilation Techniques..................................................... Dilation of Peptic Strictures........................... . Pneumatic Dilation for Achalasia......................... Dilation of Schatzki Rings........................................ Dilation of Caustic or Corrosive Strictures....... . Dilation of Malignant Strictures............................... Self-Bougienage....................................................... Refractory and High-Grade Strictures...................... Complications............................................................ Conclusions.................................................................
References................................................................... 30 Endoscopic Resection, Ablation, and Dissection .. Hiroyuki Ono, Stefan Seewald, and Nib Soehendra Introduction: the History of Endoscopic Treatment.. Diagnosis and Indications............................................ Pathology................................................................... New Diagnostic Technologies................................... Esophageal Cancer..................................................... Gastric Cancer............................................................ Colonic Cancer.......................................................... Treatment Procedures................................................... Principles.................................................................... Endoscopic Mucosal Resection................................. Endoscopic Submucosal Dissection......................... Complications................................................................ Hemorrhage.............................................................. Perforation.................................................................. Stenosis....................................................................... Ablation......................................................................... Conclusions.................................................................... Acknowledgments........................................................ References..................................................................... 315 315 315 315 315 315 316 316 316 316 316
316 316 316 317 318 318 318 319 319 319 320 320 323 323 323 323 324 324 325 325 326 326 326 326 327 327 327 327 328 328 331 331 332 332 332 332 332 333 334 334 334 336 337 339 339 339 339 340 340 340
Contents 31 Clipping and Suturing..................................................... 343 Keiichi Ikeda and Paul Swain Introduction....................................................................... Endoscopic Clipping.......................................................... Endoscopic Suturing.......................................................... Future Prospects................................................................ Conclusions......................................................................... Disclosures..................................................................... References.......................................................................... 343 343 344 346 346 346 346 32 Photodynamic Therapy................................................... 349 Rami J. Badreddine and Kenneth K. Wang Introduction....................................................................... Principles of PDT................................................................ Photosensitizers.................................................................. PDT Light Sources for Gastrointestinal Applications......... Light Dosimetry and Application Systems......................... Clinical Applications and Complications of PDT in the Gastrointestinal Tract.................................. Photosensitivity.............................................................. PDT in the Esophagus..................................................... PDT in the Stomach......................................................... PDT in the
Colon............................................................ PDT in the Pancreas....................................................... PDT in the Biliary Tree................................................... Contraindications to PDT................................................ Conclusion.......................................................................... References........................................................................... 349 349 349 350 350 33 Endoscopic Treatment for GERD..................................... 357 351 351 . 351 353 354 354 354 355 355 355 Byung Moo Yoo, George Triadafìlopoulos, and Glen A. Lehman Introduction....................................................................... Radiofrequency Ablation.................................................... Injection/Implantation....................................................... Enteryx............................................................................ Gatekeeper Reflux Repair System.................................. Plexiglas.......................................................................... Endoscopic Plication Devices............................................ EndoCinch....................................................................... NDO Plicator................................................................... EsophyX.......................................................................... Medigus SRS Endoscopic Stapling System.................... Syntheon ARD Plicator.................................................... Anti-Obesity
Technique..................................................... Miscellaneous..................................................................... Conclusions......................................................................... References.......................................................................... 357 357 358 358 359 359 359 360 361 361 363 363 364 364 364 365 34 Endoscopic Papillotomy and Endoscopic Sphincterotomy............................................ 367 Christian Prinz and Meinhard Classen Introduction....................................................................... Indications.......................................................................... Main Duodenal Papilla and Minor Papilla..................... Bile Ducts......................................................................... Pancreas........................................................................... Admission, Premedication, and Instruments.................... Circumstances of Admission (In-Patient or Outpatient) Preparation..................................................................... Instruments..................................................................... Methods of Endoscopic Papillotomy.................................. Biliary Papillotomy......................................................... Precut Papillotomy......................................................... Needle-Knife Papillotomy.............................................. Fistulotomy, Papillectomy (Ampullectomy).................. 367 367 367 367 370 372 372 372 372 375 375 375 376
378 Transpancreatic Sphincter Precutting Approach........... Minor Papilla Papillotomy.............................................. Juxtapapillary Diverticula.............................................. Billroth II Gastrectomy.................................................... Rendezvous Technique.................................................... Complications of Endoscopic Papillotomy......................... Short-Term Complications.............................................. Long-Term Complications.................................................. Results and Outcome......................................................... Technical Success............................................................. EPT in Individual Indications......................................... Alternatives to EPT............................................................. References........................................................................... 378 379 379 380 380 380 380 383 384 384 384 387 388 35 Gastrointestinal Stenting................................................ 393 Todd H. Baron and Richard A. Kozarek Introduction....................................................................... Basic Principles.................................................................. Esophageal Stenting........................................................... Placement of Esophageal SEMS...................................... Efficacy and Complications............................................. Self-Expanding Plastic Stents......................................... Biodegradable
Stents...................................................... Treatment of Malignant Esophageal Fistula.................. Placement of Self-Expanding Stents for Benign Disease Malignant Gastric Outlet Obstruction.............................. Gastroduodenal and Small-Bowel Self-Expanding Stents....................................................... Colonic Obstruction........................................................... Stent Types..................................................................... Patient Preparation......................................................... Placement Techniques.................................................... Conclusions......................................................................... References........................................................................... 393 393 393 393 395 396 396 396 397 397 397 398 399 400 400 400 400 36 Biliary and Pancreatic Stenting....................................... 403 Guido Costamagna, Pietro Familiari, and Andrea Tringali Introduction....................................................................... Types of Stent.................................................................. Stenting Technique............................................................. Positioning of Plastic Stents........................................... Metal Stent Deployment................................................ Management of Malfunctioning Stents............................. Plastic Stents....................................................................
SEMS................................................................................ Biliary Stenting.................................................................... Malignant Strictures....................................................... Benign Indications........................................................... Pancreatic Stenting............................................................. Chronic Pancreatitis....................................................... Other Pancreatic Indications........................................... Future Developments in Biliopancreatic Stenting............. Conclusions......................................................................... References........................................................................... 403 403 406 406 407 408 408 409 413 413 415 418 418 419 419 420 420 37 Intestinal Decompression................................................ 425 Todd H. Baron and Faris M. Murad Introduction....................................................................... Gastric and Small-Bowel Decompression......................... Short-Term Decompression........................................... Long-Term Decompression............................................. Colonic Decompression...................................................... Functional Obstruction.................................................... Mechanical Obstruction.................................................. References........................................................................... 425 425 425 425 426 426 427 429 XIX
Contents 38 Approach to Gastrointestinal Foreign Bodies.............. 431 Benjamin K. Poulose and Jeffrey L. Ponsky Approach to the Patient with Foreign-body Ingestion ... Food Bolus Impaction........................................................ Coins................................................................................... Sharp Objects..................................................................... Batteries and Magnets...................................................... Bezoars............................................................................... Unusual Foreign Bodies..................................................... Rectal and Colonic Foreign Bodies.................................... Surgically Assisted Endoscopic Foreign-BodyRemoval .. Conclusion.......................................................................... References.......................................................................... 431 431 433 435 436 438 438 438 440 440 440 39 Biliary Lithotripsy............................................................ 443 Chan-Sup Shim Introduction........................................................................ Indications.......................................................................... Equipment and Techniques............................................... Peroral Cholangioscopy................................................. Percutaneous Choledochoscopy.................................... Mechanical Lithotripsy (ML).......................................... Shock-Wave
Lithotripsy................................................. Electrohydraulic Lithotripsy (EHL)................................. Laser Lithotripsy ( LL)...................................................... Extracorporeal Shock-Wave Lithotripsy (ESWL)......... Novel Application of Direct Cholangioscopy................ Results of Lithotripsy.......................................................... Mechanical Lithotripsy (ML).......................................... Electrohydraulic Lithotripsy (EHL)................................. Laser Lithotripsy (LL)...................................................... Extracorporeal Shock-Wave Lithotripsy (ESWL)......... Complications..................................................................... How to Manage Trapped Baskets.................................. Biliary Stent Placement as an Alternative Procedure .. Conclusions........................................................................ References.......................................................................... 443 443 443 443 443 445 449 449 450 451 452 453 453 453 454 454 454 454 454 455 456 40 Percutaneous Endoscopic Gastrostomy andjejunostomy................................................................ 459 Sreeni Jonnalagadda and Steven A. Edmundowicz Introduction......................................................................... Indications........................................................................... Contraindications.............................................................. Patient
Preparation............................................................ Procedure............................................................................. Optimal PEG Site........................................................... Pull-Type (Ponsky-Gauderer) Gastrostomy................ Push-Type (Sacks-Vine) Gastrostomy......................... Introducer-Type (Russell) Gastrostomy.................... Post Procedure............................................................ Endoscopically Placed Gastrojejunostomy.................... Direct Percutaneous Endoscopic Jejunostomy........... Complications.................................................................. Replacement/Removal of PEG..................................... Conclusion..................................................................... References....................................................................... 41 Therapeutic Endosonography.................................. 459 459 459 460 460 460 462 464 464 466 466 466 467 468 471 471 473 Jan-Wemer Poley and Marco J. Bruno Introduction.................................................................... Equipment....................................................................... EUS-Guided Celiac Plexus Neurolysis............................. EUS-Guided FNI in the Treatment of Pancreatic Canee՛՛ EUS-Guided Implantation of Radiopaque Markers (Fiducials)........................................................................... EUS-Guided Drainage of Pancreatic Fluid Collections, Abscesses, and Infected Necroses........... EUS-Guided
Drainage of the Biliary System................ EUS-Guided Hepaticogastrostomy............................. EUS-Guided Choledochoduodenostomy........................ EUS-Guided Cholecystostomy.................................... EUS-Guided Pancreatic Duct Drainage and Rendezvous Future Indications for Therapeutic EUS........................ EUS and Vascular Interventions................................... EUS and NOTES.............................................................. References....................................................................... 473 473 473 474 475 475 479 479 480 481 481 : 83 483 483 483 VI Upper Gastrointestinal Tract Disease Section editors: Charles J. Lightdale, Hisao Tajiri, Jaques j.C.j.M. Bergman 42 Esophageal Diseases........................................................ 488 Neil Gupta and Prateek Sharma Anatomy.............................................................................. Mucosal Diseases................................................................ Reflux Esophagitis.......................................................... Infectious Esophagitis..................................................... Pill-Induced Esophagitis................................................. Corrosive Esophagitis..................................................... Radiation Esophagitis..................................................... Barrett’s Esophagus........................................................ Nonendoscopic Tube Trauma........................................ Heterotopic Gastric
Mucosa.......................................... Mallory-Weiss Tears....................................................... Rings and Strictures............................................................ Schatzki Ring................................................................... Peptic Strictures.............................................................. Eosinophilic Esophagitis................................................. Diaphragmatic Hernias....................................................... Sliding Hiatal Hernias..................................................... Paraesophageal Hernias................................................. XX 488 488 488 490 491 492 492 493 495 495 495 496 496 496 497 497 498 498 Diverticula........................................................................... Zenker Diverticula.......................................................... Other Esophageal Diverticula........................................ Vascular Diseases................................................................ Varices............................................................................. Arteria Lusoria................................................................ Mass Lesions of the Esophagus.......................................... Benign Tumors................................................................ Malignant Tumors.......................................................... References........................................................................... 498 498 499 499 499 501 501 501 503 504 43 Gastric
Diseases.................................................................. 511 ¡(ristien MAJ. Tytgat and Guido N.J. Tytgat Normal Stomach-Anatomical Variants— Mucosal Prolapse and Tearing.......................................... Normal Stomach.............................................................. Hiatal Hernia.................................................................... Paraesophageal Hernia................................................... Mixed Axial and Paraesophageal Herniation............... Upside-Down Stomach................................................... 511 511 512 514 514 514
Contents Gastric Diverticula................................................ Gastroesophageal Prolapse.................................. Mallory-Weiss Tears............................................ Gastritis................................................................... Endoscopic Aspects.............................................. Histological Aspects............................................ Nosological Causes of Gastric Inflammation....... Infectious Gastritis.............................................. Autoimmune Gastritis......................................... Drug-Induced Gastric Mucosal Damage............ Hypertrophic-Hyperplastic Gastritis.................. Granulomatous Gastritis..................................... Enterogastric or Biliary Reflux Gastritis.............. Physical-Chemical and Caustic Gastritis............ Stress-induced Gastritis....................................... Ischemia and Vasculitis....................................... Miscellaneous Idiopathic Conditions.................. Vascular Disorders.................................................. Gastric Ulcer............................................................ Gastric Polyps........................................................... Epithelial Lesions.................................................. Subepithelial Mesenchymal Polypoid Lesions... Malignant Epithelial Tumors, Gastric Cancer......... Early Gastric Cancer............................................ Advanced Gastric Cancer..................................... Malignant Nonepithelial
Tumors......................... Postoperative Stomach............................................ References................................................................ 514 514 514 515 515 518 519 520 523 524 526 526 527 527 528 528 529 531 533 535 535 540 541 542 544 547 549 552 44 Duodenal and Small-Intestinal Diseases............ 555 Blair S. Lewis Small-Bowel Tumors................................................ Stromal Tumors................................................... Adenoma and Adenocarcinoma........................... Nonneoplastic Polyps........................................... Lipomas................................................................ Carcinoid.............................................................. Lymphoma........................................................... Kaposi’s Sarcoma.................................................. Metastatic Disease................................................ Ulcerative and Erosive Diseases of the Small Bowel Crohn’s Disease................................................... Zollinger-Ellison Syndrome................................ Infections.............................................................. Medication Effects................................................ Vasculitis.............................................................. Radiation Injury................................................... Mesenteric Ischemia............................................ Graft-versus-Host Disease (GVHD)..................... Congenital Lesions...................................................
555 557 557 558 558 559 559 560 560 560 560 560 561 561 561 562 562 562 563 Diverticula and Duplication Cysts.................................... Meckel’s Diverticulum...................................................... Duplication Cysts............................................................... Vascular Anomalies............................................................... Malabsorption...................................................................... Celiac Disease.................................................................... Whipple’s Disease............................................................. Amyloid............................................................................. References............................................................................. 563 563 564 564 567 567 567 568 568 45 Diseases of the Ampulla...................................................... 571 Nalini M. Guda and Joseph E. Geenen Introduction.......................................................................... Anatomic Variations............................................................. Papillitis................................................................................. Tumors of the Ampulla of Vater.......................................... Periampullary Fistula............................................................ Sphincter of Oddi Dysfunction............................................. Diseases of the Minor Papilla...............................................
References............................................................................. 571 571 572 573 574 574 575 575 46 Upper Gastrointestinal Bleeding Disorders...................... 577 Shiv K. Sarin, Vikram Bhatia, Justin C.Y. Wu, and Joseph J.Y. Sung Variceal Bleeding in Cirrhosis............................................... 577 Shiv K. Sarin and Vikram Bhatia Anatomy of Esophageal and Gastric Varices.................... 577 Classification Systems...................................................... 577 Local and Systemic Hemodynamics................................. 577 Predictors of First Variceal Bleed...................................... 578 Natural History................................................................... 579 Treatment of Acute Esophageal Variceal Hemorrhage.. 580 Treatment of Acute Gastric Variceal Hemorrhage......... 583 Prophylaxis........................................................................ 586 Nonvariceal Upper Gastrointestinal Bleeding...................... 587 Justin C.Y. Wu and Joseph J.Y. Sung Introduction...................................................................... 587 Preendoscopy Management............................................. 587 Peptic Ulcer........................................................................ 588 Gastric and Duodenal Erosion and Hemorrhage........... 589 Mallory-Weiss Syndrome................................................. 589 Esophagitis and Esophageal Ulcers.................................. 589 Dieulafoy Lesion.................................................................
590 Gastric Antral Vascular Ectasia.......................................... 590 Upper Gastrointestinal Tumors........................................ 591 Other Rare Causes of Nonvariceal Upper Gastrointestinal Bleeding................................................. 591 References............................................................................. 591 VII Lower Gastrointestinal Tract Diseases Section editors: Charles ]. Lightdale, Guido N.j. Tytgat, Alexander Meining 47 Colorectal Disorders..................................................... 596 Witold Bartnik, Jacek Pachlewski, and Jarosław Regula Colorectal Polyps................................................................ Hereditary Colorectal Syndromes..................................... Colorectal Cancer................................................................ Ischemic Colitis.................................................................. Pseudomembranous Colitis................................................ Bacterial Colitis.................................................................. Tuberculosis....................................................................... 596 602 604 606 606 607 608 Viral Colitis......................................................................... Diverticular Disease........................................................... Microscopic Colitis............................................................. Drug-Induced and Chemical-Induced Colopathy........................................................................... Melanosis
Coli.................................................................... Pneumatosis Cystoides Intestinalis.................................... Solitary Rectal Ulcer Syndrome......................................... Colitis Cystica Profunda...................................................... 609 609 610 611 611 612 612 613 XXI
Contents Stercoral Ulcers................................................................... Lipomas.............................................................................. Large-Bowel Carcinoids..................................................... Colonic Endometriosis....................................................... Metastases to the Large Bowel.......................................... Other Diseases................................................................... References.......................................................................... 613 613 613 614 614 614 614 48 Endoscopy of Inflammatory Bowel Disease................. Wojciech Błoński, David Kotlyar, and Gary R. Lichtenstein Introduction......................................................................... Preparation for Colonoscopy.............................................. Endoscopic Evaluation of Disease Activity........................ Ulcerative Colitis............................................................ Crohn’s Disease................................................................ Endoscopic Characteristics of IBD..................................... Colonoscopy................................................................... Complications.................................................................. Normal Colonic Mucosa................................................. Ulcerative Colitis............................................................ Crohn’s Disease................................................................ Upper
Endoscopy................................................................ Ulcerative Colitis............................................................ Crohn’s Disease................................................................ Surgery for IBD................................................................... Pouchitis........................................................................... Postoperative Recurrence of Crohn’s Disease............... Complications of Crohn’s Disease.................................... Strictures......................................................................... Acute Lower Gastrointestinal Bleeding.......................... Differentia] Diagnosis..................................................... Cancer and IBD................................................................... Risk of Colorectal Cancer............................................... Dysplasia......................................................................... Endoscopic Surveillance................................................. Endoscopic Features Associated with Dysplasia........... Endoscopic Detection of Colonic Neoplasia.................. Capsule Endoscopy........................................................ Enteroscopy......................................................................... Push Enteroscopy............................................................ Double-Balloon Enteroscopy.......................................... Perioperative Endoscopy................................................... Endoscopic Retrograde
Cholangiopancreatography....... Endoscopic Ultrasonography (EUS)................................... Conclusions......................................................................... Acknowledgment................................................................ References........................................................................... 617 617 617 617 617 618 620 620 620 620 620 622 625 625 625 626 626 626 627 627 627 627 630 630 630 630 632 632 634 634 634 634 635 636 636 636 637 637 49 Lower Intestinal Bleeding Disorders............................. Juergen Bamert and Helmut Messmann Definitions........................................................................... General Aspects.................................................................. Epidemiology.................................................................. Clinical Course and Prognosis...................................... Diagnostic Approach........................................................... History........................................................................... Physical Examination..................................................... Laboratory Studies.......................................................... Endoscopy....................................................................... Nonendoscopic Methods............................................... Differential Diagnosis......................................................... Colon.............................................................................. Small
Bowel............................................................... Therapy.......................................................................... Initial Resuscitation..................................................... Endoscopy.............................................................. Radiologic Angiotherapy............................................ Surgery......................................................................... Pharmacotherapy......................................................... Differential Endoscopic Therapy.................................... Impact of Endoscopy on the Outcome........................... References..................................................................... 50 Anorectal Disease.......................................................... Joep F.W.M. Bartelsman Proctitis............................................................................. Infectious Proctitis......................................................... Gonorrhea..................................................................... Chlamydial Infection............................................... Syphilis......................................................................... Herpes Simplex Virus (HSV).................................... CMV Infection............................................................ Ischemic Proctitis.......................................................... Radiation Proctitis..................................................... Solitary Rectal Ulcer Syndrome................................. Anal
Fissure....................................................................... Hemorrhoids................................................................ Rectal Prolapse............................................................ Condylomata Acuminata (Genital Warts).................... Anal Cancer..................................................................... Anal Intraepithelial Neoplasia...................................... References..................................................................... 641 641 641 641 641 641 641 641 642 642 644 645 645 548 050 450 550 551 651 551 552 63 54 59 659 559 559 459 060 60 360 360 360 3352 363 563 64 65 565 566 567 Vlil Blliopancreatic, Hepatic, and Peritoneal Diseases Section editors: Charles ]. Lightdale, Meinhard Classen, D. Nageshwar Reddy 51 Biliary Tract Diseases....................................................... Nathan J. Shores and John Baillie Introduction......................................................................... Procedures........................................................................... General Indications for ERCP and EUS.......................... Antibiotic Coverage......................................................... Contrast Allergy.............................................................. Difficult Anatomy............................................................ The Normal Cholangiogram............................................... Cholelithiasis.......................................................................
Choledocholithiasis............................................................ 670 670 670 670 670 671 671 671 672 673 Background..................................................................... ERCP, EUS, or MRCP to Diagnose Choledocholithiasis?. Endoscopic Management................................................ Gallbladder Lesions............................................................ Biliary Malignancy.............................................................. Malignancy Affecting the Biliary Tree........................... A Potpourri of Imaging Techniques............................... EUS or ERCP in the Diagnosis of Biliary Malignancy... Tissue Sampling.............................................................. Staging of Bile Duct Tumors.......................................... Biliary Stenting................................................................ 673 673 674 679 680 680 680 680 681 682 682
Contents Miscellaneous Conditions in the Biliary Tree.................... Primary Sclerosing Cholangitis..................................... Choledochal Cysts.......................................................... Sphincter of Oddi Dysfunction....................................... Biliary Parasites.............................................................. Some Recent Developments........................................... References....................................................................... 682 682 684 685 687 687 688 52 Pancreatic Disease........................................................... Evan L Fogel, Furquaan Ahmed, and Stuart Sherman Introduction....................................................................... Developmental Anomalies of the Pancreas....................... Pancreas Divisum: Diagnosis and Therapy.................... Annular Pancreas............................................................ Pancreatic Agenesis......................................................... Anomalous Pancreaticobiliary Ductal Junction............ Acute Pancreatitis.............................................................. Acute Gallstone Pancreatitis........................................... Acute Recurrent Pancreatitis of Known or Unknown Cause.............................................................. Unresolving Acute Pancreatitis..................................... Chronic Pancreatitis........................................................... Pancreatic Strictures....................................................... Pancreatic
Ductal Stones................................................ Pancreatic Pseudocysts and Fistulas.............................. Biliary Obstruction in Chronic Pancreatitis.................... 693 693 693 693 700 701 701 702 702 704 705 707 707 709 712 714 Autoimmune Pancreatitis.............................................. Sphincter of Oddi Dysfunction....................................... Pancreatic Neoplasms ....................................................... Conclusions......................................................................... References........................................................................... 715 715 716 719 719 53 Diseases of the Liver and Peritoneum........................... H.Juergen Nord Introduction....................................................................... Diseases of the Liver and Biliary System........................... Normal Findings............................................................ Fatty Liver....................................................................... Acute and Chronic Hepatitis........................................... Focal Liver Lesions.............................................................. Benign Focal Lesions....................................................... Focal Malignant Lesions.................................................. Peritoneal Disorders........................................................... Primary Peritoneal Disease............................................. Metastatic Disease........................................................... Infectious
Diseases......................................................... Ascites of Unknown Cause............................................. Perihepatitis.................................................................... Chronic and Acute Pain Syndromes.............................. Acute Abdomen, Blunt Abdominal Trauma.................... References........................................................................... 723 723 723 723 724 725 729 729 731 734 734 735 736 736 736 736 737 737 IX Infectious Diseases of the Gastrointestinal Tract Section editors: Cuido N.J. Tytgat, Charles J. Lightdale, Michael B. Wallace 54 Infectious Diseases of the Intestines.............................. Paul Feuerstadt and Lawrence J. Brandt Introduction....................................................................... Clinical Features.................................................................. History............................................................................ Physical Examination..................................................... Diagnostic Testing........................................................... Differentiating Infectious Colitis from Inflammatory Bowel Disease......................................... Treatment........................................................................... Specific Organisms............................................................ Viruses............................................................................ Bacteria........................................................................... Parasitic
Diseases............................................................ References........................................................................... 55 Intestinal Abnormalities in AIDS.................................... Andrew T. Pellecchia and Lawrence J. Brandt Introduction....................................................................... Dysphagia and Odynophagia............................................ Etiology........................................................................... Candida Esophagitis....................................................... Cytomegalovirus............................................................ 742 742 742 742 742 742 743 744 745 745 745 748 750 753 753 753 753 754 754 Herpes Simplex Virus..................................................... Idiopathic (Aphthous) Ulcers......................................... Other................................................................................ Abdominal Pain.................................................................. Gastric Diseases.................................................................. Cytomegalovirus............................................................. Kaposi’s Sarcoma............................................................ Lymphoma..................................................................... Mycobacterium avium complex (MAC)......................... Pancreaticobiliary Diseases................................................ Pancreatitis..................................................................... Acalculous
Cholecystitis.................................................. AIDS Cholangiopathy..................................................... Diarrhea.............................................................................. Pathogens....................................................................... Diagnostic Yield.............................................................. Specific Pathogens and Endoscopic Appearance........... Gastrointestinal Bleeding.................................................. AIDS-Related Upper Gastrointestinal Bleeding............. AIDS-Related Lower Gastrointestinal Bleeding............. AIDS and the Endoscopist.................................................. Conclusions......................................................................... References........................................................................... 754 754 754 755 755 755 755 756 756 756 756 756 757 757 757 758 759 760 760 760 761 761 761
Contents X Pediatric Endoscopy Section editors: Guido N.J. Tytgat, Charles J. Lightdale, Meinhard Classen 56 Pediatric Endoscopy........................................................ 766 Victor L Fox XXIV Introduction........................................................................ Patient Preparation............................................................ Emotional Preparation................................................... Dietary Restrictions........................................................ Sedation.......................................................................... Antibiotic Prophylaxis..................................................... Contraindications............................................................ Equipment.......................................................................... Upper Gastrointestinal Endoscopy.................................... Indications and Specific Diagnostic and Therapeutic Applications..................................................................... Enteroscopy........................................................................ Colonoscopy...................................................................... Bowel Preparation.......................................................... Equipment...................................................................... 766 766 766 767 767 769 769 769 769 770 782 783 783 784 Index......................................................................................... 806 Basic Technique..............................................................
Polypectomy................................................................... Indications and Contraindications................................. Specific Diagnostic and Therapeutic Applications........... Endoscopic Retrograde Cholangiopancreatography....... Introduction..................................................................... Equipment....................................................................... Patient Preparation and Sedation................................. Basic Technique........................................................ Role of the Pediatric Endoscopist............................. Contraindications........................................................ Diagnostic and Therapeutic Indications........................ Biliary Conditions....................................................... Pancreatic Conditions................................................... Gastrointestinal Endosonography............................... References................................................................... 784 784 785 786 789 789 790 790 790 790 790 790 791 796 798 801
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Contents I Development of Endoscopy Section editors: Meinhard Classen, Guido N.j. Tytgat, Charles ]. Lightdale 1 Two Centuries of Digestive Tract Endoscopy: a Concise Report. 2 Meinhard Classen 2 Introduction. Nineteenth-Century Pioneers. Rudolf Schindler and the “Semiflexible” Endoscope. Fiberglass Endoscopy and Electronic Endoscopy. Japanese Contributions to Digestive Tract Endoscopy. Colonoscopy. Endoscopic Retrograde Cholangiopancreatography. Percutaneous Transhepatic Cholangiography. Enteroscopy. Therapeutic Endoscopy. Endoscopic Ultrasonography. Laparoscopy. Summary and Prospects. References. 12 Quality Assurance. 15 2 2 3 4 4 6 6 6 8 8 10 11 11 Anthony T. R. Axon Introduction. History of Quality Assurance. Quality Assurance in
Endoscopy. Quality Indicators. Preprocedural Quality Indicators. Intraprocedural Quality Indicators. Postprocedural Quality Indicators. Nursing Involvement in Quality Assurance. How Should Quality Indicators Be Recorded?. Quality Assurance and Information Technology. How Should Quality Assurance Data Be Used?. The Endoscopy Global Rating Scale. Impact of Quality Assurance on Endoscopic Practice. What Are the Next Steps?. Managing the Endoscopy Unit. References. 3 Advanced Imaging in Endoscopy. 15 15 16 16 16 17 17 18 18 18 19 19 20 20 20 20 21 Ralf Kiesslich and Hisao Tajiri Introduction. High-Resolution and Magnifying Endoscopy. Chromoendoscopy. Digital Chromoendoscopy. Functional Imaging. Point
Spectroscopy. Fluorescence Spectroscopy. Elastic Scattering Spectroscopy. 21 21 21 22 24 24 24 24 Raman Spectroscopy. Multimodal Spectroscopy. Autofluorescence Imaging. Optical Coherence Tomography. Endocytoscopy. Confocal Laser Endomicroscopy. Principle of Confocal Microscopy. Endoscopic Confocal Microscopy. Contrast Agents. Clinical Data in Endomicroscopy. Barrett’s Esophagus. Gastritis and Gastric Cancer. Celiac Disease. Colorectal Cancer. Ulcerative Colitis. Microscopic Colitis. Future of Endomicroscopy.
Conclusions. References. 24 24 24 25 26 27 27 27 27 28 28 29 30 31 32 32 32 32 34 4 Evidence-Based Endoscopy. 37 John M. Inadomi and Ma Somsouk Background. Studies of Therapy. Clinical Scenario. Are the Results Valid?. What Are the Results?. Will the Results Help Me in Caring for My Patients? . Resolution of the Clinical Scenario. Studies of Diagnosis. Clinical Scenario. Are the Results Valid?. What Are the Results?. Will the Results Help Me in Caring for My Patients?. Resolution of the Clinical Scenario. Studies of Harm. Clinical Scenario. Are the Results Valid?. What Are the
Results?. Will the Results Help Me in Caring for My Patients? . Resolution of the Clinical Scenario. How to Use an Article about Prognosis. Clinical Scenario. Are the Results Valid?. What Are the Results?. Will the Results Help Me in Caring for My Patients? . Resolution of the Clinical Scenario. Conclusions. References. 37 37 37 37 38 39 39 39 39 39 40 41 41 42 42 42 42 43 43 43 43 43 44 44 45 45 45 ХШ
Contents II The Patient and Endoscopy Section editors: Cuido N.j. Tytgat, Meinhard Classen, Charles ]. Lightdale 5 Informed Consent for Gastrointestinal Endoscopy. 48 Spiros D. Ladas 6 Endoscopy in Special Clinical Situations. 67 Douglas C. Adler and David Björkman Historical Perspectives. The Concept of Informed Consent. Declarations Protecting Patients’ Rights. Informed Consent for Gastrointestinal Endoscopy. Exceptions to Informed Consent. Additional Issues on Informed Consent. Medicolegal Issues. Breach of Duty. Malpractice in Gastrointestinal Endoscopy. Causes of Malpractice Claims in Endoscopy. How and When Informed Consent Should be Obtained . Additional Issues on Obtaining Informed Consent. Personnel Responsible for Obtaining Informed Consent Open-Access Gastrointestinal Endoscopy. Obtaining Informed Consent for Teaching and Learning Endoscopy. Obtaining Informed Consent for Endoscopy-Based Research. Obtaining Informed Consent for Live Endoscopy Demonstrations. Informed Consent and Endoscopy by Nonphysicians.
References. 48 48 48 49 49 49 50 50 50 51 51 52 52 52 Patient Preparation and Sedation for Endoscopy. 57 Introduction. Endoscopy in Pregnant and Lactating Women. Endoscopy in Pregnant Patients. Endoscopy in Lactating Patients. Endoscopy in the Elderly. Endoscopy in Patients Requiring Anticoagulation or Antiplatelet Medications. Management of Antiplatelet Agents. Management of Warfarin and Heparins. Endoscopy in Patients with Hemophilia. Restarting Anticoagulation. Conclusion. References. 8 The Endoscopy Suite. 52 53 53 53 54 Jenifer R. Lightdale Levels of Sedation. Patient Preparation and Assessment for Sedation. Fasting Instructions. Patient Medical History and Examination. Airway Evaluation. Special Patient Considerations. Procedures without Sedation. Pharmacological Options for
Endoscopy. Topical Agents. Benzodiazepines. Diazepam. Midazolam. Opioids. Pethidine (Meperidine). Fentanyl. Adjuvant Agents. Propofol. Antagonists. Flumazenil. Naloxone. Care and Monitoring of the Patient during Endoscopy. Electronic Monitoring and Intervention. References. 7 57 58 58 58 59 60 60 60 61 61 61 61 62 62 62 62 62 63 63 63 63 63 64 67 67 ■57 58 69 71 72 72 72 75 Hans-Dieter Allescher General Questions and Considerations. . Guidelines for Planning an Endoscopy Suite. Pathways for Patients, Staff and Materials. Location of the Unit. Number of
Rooms. Radiographic Requirements. . The Endoscopic Examination Room. Size of the Rooms. Equipment. Monitor Systems and Anesthesia. Video Integration and Computer-Based Documentation. Endoscopes and Endoscopic Equipment. Endoscopic Ultrasound and Laser Treatment Roer;; Radiography Room. Preparation and Recovery Room. Cleaning and Disinfection Area. Staffing. References. 75 75 75 76 77 78 78 78 78 79 9 Cleaning and Disinfection in Endoscopy. 83 79 79 80 30 80 30 80 Michael Jung and Thierry Ponchon Spaulding Criteria. Mechanisms of Infection in Endoscopy. Indicator Bacteria. Infections in Endoscopy. Guidelines. Reprocessing of Endoscopic Accessories. New Agents and Disinfectants. Quality Assurance in Endoscope Reprocessing. Infections Occurring in Endoscopy (Outbreak Management).
Conclusions. References. 83 83 84 84 85 86 86 87 88 88 88
Contents III Teaching and Learning Section editors: Meinhard Classen, Guido N.j. Tytgat, Charles ]. Lightdale 10 Education and Training. 92 Juergen Hochberger, Juergen Maiss, Kai Matthes, Guido Costamagna, and Robert H. Hawes Introduction. Clinical Education. Clinical Training in EGD and Colonoscopy: Studies and Guidelines. Studies and Guidelines on Clinical Training in ERCP . Practical Training in ERCP. Complementary Video Courses. Current Training Models. Plastic Phantoms and OtherStatic Models. Computer Simulators. 92 92 92 93 93 94 94 94 95 Training Courses with Live Animals. Ex Vivo Porcine Tissue Models (EASIE, Erlanger Endo-Trainer, EASIE-R). Training Courses. Comparison of Teaching Models for Training Courses. Acquiring Teaching Skills as a Tutor. Open Questions and Future Prospects. Maintaining Skills in Complex Procedures. Incorporating Simulator Training into Educational
Programs. Training in NOTES and the Future Endoscopic Interventionalist. References. 96 98 100 101 102 102 102 102 102 102 IV Diagnostic Procedures and Techniques Section editors: Meinhard Classen, Guido N.j. Tytgat, Michael B. Wallace 11 Upper Gastrointestinal Endoscopy. 106 Michel Delvaux and Gerard Gay Technical Description of the Gastroscope. Description of the Procedure. Sedation. Preparation of the Patient. Insertion of the Endoscope. Advancement of the Endoscope and Maneuvering for a Complete Examination. After the Procedure. Normal Endoscopic Anatomy of the Upper Gastrointestinal Tract. Esophagus. Stomach. Duodenum. Anatomical Variants. Surgically Modified
Anatomy. Difficult-to-Examine Anatomical Locations. Indications and Contraindications. Indications. Contraindications. Appropriateness of Indications. Complications. Documentation of an EGD Procedure. Conclusion. References. 106 106 106 107 107 12 Enteroscopy Techniques. 119 Potential Indications for VCE. Interplay between VCE and Deep Enteroscopy. Summary. References. 131 131 132 132 14 Colonoscopy: Basic Instrumentation and Technique. 133 Brian Saunders Introduction. Balloon-Assisted Enteroscopy. Intraoperative Enteroscopy. References. 119 119 123 124
Introduction. Indications. Contraindications. Bowel Preparation. Instructions for Morning and Afternoon Appointments Sedation. Antispasmodics. Equipment for Colonoscopy. Carbon Dioxide Versus Air Insufflation. Accessories. Imaging during Colonoscopy. Fluoroscopy. Magnetic Endoscope Imaging. Colonoscope Insertion: Technique. General Principles. Instrument Handling. Ancillary Techniques for Colonoscope Insertion. Anus and Rectum. Sigmoid Colon. Descending Colon and Splenic Flexure. Transverse Colon and Hepatic Flexure. Ascending Colon, Cecum, and Terminal Ileum.
Is Total Colonoscopy Achievable in All Patients?. Examination Technique during Withdrawal. Complications. References. 13 Wireless Video Capsule Endoscopy. 127 15 ERCP. 108 109 109 109 110 Ill Ill 112 114 114 114 114 114 115 115 116 116 Blair S. Lewis and Kiyonori Kobayashi David Cave Introduction. Technology. Limitations. Complications. Indications and Contraindications. 127 127 128 129 129 133 133 134 134 135 135 136 136 138 139 139 139 140 141 141 141 142 142 143 145 146 147 148 148 148 149 151 Gregory B. Haber, Curpal S. Sandha, and Meinhard Classen Historical Background Indications. Facilities. Equipment. Endoscopes. 151 151 151 152 152
Contents Cannulating Devices. Contrast Agents. Technique. Patient Preparation and Sedation. Procedure. Oropharyngeal Intubation. Cannulating the Minor Papilla. Challenging Scenarios. Complications. Pancreatitis. Future Directions. References. 152 153 153 153 154 154 154 157 157 158 158 159 16 Peroral Cholangioscopy. Axel Eickhoff and Juergen F. Riemann Introduction. Procedure. Instruments and Technique. New Intraductal Endoscopy Techniques. Complications. Clinical
Applications. Diagnostic Peroral Cholangioscopy. Therapeutic Peroral Cholangioscopy. Conclusions. References. 160 17 Percutaneous Transhepatic Cholangiography and Cholangioscopy. Jean-Pierre Charton, Chan Sup Shim, and Horst Neuhaus Introduction. Indications. Contraindications. Equipment. Cholangioscopes. Lithotriptors. Patient Preparation. Procedures. Percutaneous Transhepatic Cholangiography. Percutaneous Transhepatic Cholangiographie Drainage. Percutaneous Transhepatic Cholangioplasty, Biliary Stent Placement, and Photodynamic Therapy. Percutaneous Transhepatic Cholangioscopy. Percutaneous Stone
Removal. Postprocedural Care of the Transhepatic Tract. Results. PTC, PTCD, Cholangioplasty, and Stent Placement. Diagnostic Percutaneous Transhepatic Cholangioscopy. Therapeutic Percutaneous Transhepatic Cholangioscopy Complications and Management. Conclusions. References. XVI І 160 160 160 160 163 163 163 164 165 165 Endoscopic Findings and Therapy in the Early Postoperative Period. Endoscopic Findings and Therapy in the Late Postoperative Period and Follow-Up. Endoscopic Therapeutic Interventions. Stomal Stenosis and Stoma/Outlet Obstruction. Dilated Gastrojejunostomy after Gastric Bypass Surgery. Staple-Line Dehiscence and Gastrogastric Fistula in VBG and RYGB. Band Erosion. Endoscopic Access to the Bypassed Stomach and Duodenum and to the Papilla of Vater in RYGB . Conclusions. References. 19 Magnifying
Chromocolonoscopy and Tattooing Shin-ei Kudo, Hideyuki Miyachi, and Shungo Endo Introduction. Practical Aspects of Diagnosis Based on Magnifying Endoscopy. Recent Trends in Endoscopic Diagnosis of the Ty pe V Pit Pattern. Treatment Policies Based on Morphological Development and Pit Patterns. Endoscopic Tattooing Technique. References. 186 187 187 188 190 190 191 192 193 193 197 197 197 199 200 201 202 167 167 167 167 167 168 168 168 168 168 168 169 170 171 171 173 173 174 174 175 176 176 18 Endoscopic Therapy in Obesity. Elisabeth M.H. Mathus-Vliegen 179 Introduction. Endoscopic Treatments for Obesity. Intragastric Balloon Treatment. Other Endoscopic Modalities. Endoscopic Treatment for Bariatric Surgery Complications. Surgical Procedures. Role of Endoscopy. Normal Endoscopic Findings. Reported
Complications. 179 179 179 182 182 182 184 184 185 20 Tissue and Fluid Sampling. Koji Matsuda and Hisao Tajin Introduction. Devices. Biopsy Forceps. Polypectomy Snare. Brush Cytology. Fine-Needle Aspiration Cytology. . EGD. . ■ · Esophagus. Stomach. Duodenum. Enteroscopy. · Colonoscopy. ERCP. EUS-FNA. Sampling of Body Fluids Summary. References. 203 21 The Contribution of Histopathology to Endoscopy— Karel Geboes Introduction. Endoscopy and the Diagnostic Yield of Histopathology. --------------- Г J — u Jmmunohisiochemistry and Other Ancillary Techniques. Role of Pathology in the
Esophagus. Inflammatory Conditions. Neoplastic Conditions. Role of Pathology in the Stomach. Inflammatory Conditions. Neoplastic Conditions. Role of Pathology in the Duodenum. Inflammatory Conditions. Neoplastic Conditions. Role of Pathology in the Terminal Ileum and Colon. inflammatory Conditions. Neoplastic Conditions. 211 203 203 203 203 203 203 206 -06 206 206 206 206 206 211 2П 212 213 213 214 215 215 217 217 217 219 219 219 221
Contents Conclusions. References. 222 222 22 Diagnostic Endoscopic Ultrasonography. Abdel M. Kassem, Thomas Rösch Introduction. Available Instruments and Scanning Principles. Basics of EUS-Guided Puncture Techniques. Clinical Background and Prerequisites of EUS and EUS-Guided Fine-Needle Puncture. Examination Technique and Normal Findings. Preparation, Sedation, and Complications. Upper Gastrointestinal Tract. Mediastinum. Pancreas and Biliary Tract. Colorectum. Pathological Findings: General Principles. Tumor Staging in the Gastrointestinal Tract. Submucosal Lesions. Tumor Diagnosis and Staging in the Pancreaticobiliary Tract. Benign Lesions and Differential Diagnosis. Fine-Needle Puncture: Accuracy, Pitfalls, and Limitations. Further
Developments. Training in EUS. References. 225 23 Laparoscopic, Natural Orifice, and LaparoscopyAssisted Surgery: New Paradigms in Minimally Invasive Therapy. Robert H. Hawes, Stefan von Delius, D. Nageshwar Reddy, and Hubertus Feußner Introduction. Robert H. Hawes Laparoscopic Cholecystotomy. Stefan von Delius Patient Selection. Technique. Effectiveness of LCT. 225 225 227 229 230 230 230 231 231 233 233 233 235 236 238 240 240 241 241 245 245 246 246 246 248 Percutaneous Cholecystostomy. Endoscopic Gallbladder Drainage. Natural Orifice Transluminal Endoscopic Surgery. D. Nageshwar Reddy Introduction. Transgastric Appendectomy. Transgastric Tubal Occlusion. Transvaginal Cholecystectomy. Other Access
Routes. Benefits and Pitfalls. Conclusion. Combined Laparoscopic and Endoscopic Interventions and Transcolonic/Transgastric NOTES Procedures. Hubertus Feußner Introduction. Indications. Contraindications. General Principles. General Technical Aspects. LEP Variants. Results of Laparoscopic-Endoscopic Procedures. Laparoscopic-Endoscopic Procedures as “Pseudo-NOTES”. References. 248 248 248 248 249 250 250 251 253 253 253 253 254 254 254 254 255 256 257 257 24 Liver Biopsy. 261 Andrew K. Burroughs, Marco Senzolo, and Evangelos Cholongitas Introduction. Indications. Percutaneous Liver Biopsy. Menghini
Technique. Tru-Cut Needle Biopsy. Plugged Percutaneous Liver Biopsy. Fine-Needle Aspiration Biopsy of the Liver. Ultrasound-Guided Liver Biopsy. Transvenous (Jugular) Approach. Quality of Liver Biopsies for Accurate Histológica! Interpretation. Laparoscopic Biopsy of the Liver. References. 261 261 261 262 262 264 264 265 265 267 268 268 Tissue Adhesives. Endoloops and Detachable Mini-Snares. References. 278 278 279 26 Laser Application. Hugh Barr Physics and Principles of Laser Therapy. Interaction of Laser Light with Tissue. Types of Lasers. Endoscopic Laser Therapy. Hemostasis. Palliation of Malignant Dysphagia. Ampullary and Duodenal
Neoplasia. Colorectal Cancer. Early Gastrointestinal Cancer and Precancer. Biliary Tract. Conclusions. References. 281 V Therapeutic Procedures Section editors: Cuido N.j. Tytgat, Meinhard Classen, and Charles 1. Lightdale 25 Hemostasis. Sandy H.Y. Pang and James У.ѴѴ. Lau Overview. Nonvariceal Hemorrhage. Injection Therapy. Thermal Methods. Hemoclips. Heater Probe vs. Hemoclips. Monotherapy versus Combination Treatment. Endoscopic Signs of Bleeding. Limitations of Endoscopic Therapy. Other Nonvariceal Bleeding Sources. Variceal Hemorrhage. Endoscopic Variceal Ligation. Endoscopic Injection
Sclerotherapy. Band Ligation versus Endoscopic Injection Sclerotherapy. Combining Banding Ligation and Sclerotherapy. 272 272 272 272 273 274 275 275 275 276 276 276 276 277 277 278 281 281 281 282 282 282 283 283 283 286 286 286 XVII
Contents 27 Argon Plasma Coagulation. James A. DiSario 287 Technology. Tissue Effects. Clinical Techniques. Clinical Applications and Outcomes. Tissue Ablation. Hemostasis. Zenker’s Diverticulum. Stent Manipulation. References. 287 287 288 289 289 293 295 295 296 29 Polypectomy. 299 Jerome D. Waye, Brian Saunders, Yasushi Sano, and Shinji Tanaka Principles of Colonoscopic Polypectomy. 299 Heat Sealing of Blood Vessels. 299 Type of Current. 299 Electrosurgical Unit. 299 Coaptive Coagulation. 299 Types of Polyp. 299 Chromoendoscopy. 300 Narrow-Band
Imaging. 300 Endoscopic Accessories. 302 Electrosurgical Units. 302 Injector Needles. 303 Colonoscope. 303 Carbon Dioxide. 303 Hot Biopsy Forceps. 303 Heater Probe and BICAP. 303 Argon Plasma Coagulator. 303 Detachable Loop. 303 Clips. 304 305 Snares. Prepolypectomy Laboratory Testing. 305 Aspirin and Anticoagulants. 305 305 Polypectomy Technique. 305 Polyp Position. 305 Small Polyps. 305 Snare Catheter Placement. 306 Pedunculated Polyps. 306 Sessile
Polyps. Endoscopic Mucosal Resection (EMR) and Submucosal 306 Dissection (ESD). 306 Treatment of the Polyp Base after Removal. 308 Methods for Safer Polypectomy. 308 Marking the Snare Handle. 309 Submucosal Injection for Polypectomy. Volume of Injected Fluid. 309 310 Malignant Polyps. 311 Tumor Tracking. 311 Air Aspiration. 311 The Tip of the Snare. 311 Stopping at the Line. 311 Tent the Polyp away from the Base. 311 Piecemeal Polypectomy. 312 Problems. 312 Polyp Position. 313 When to Remove Polyps. 313 Positional Changes and Abdominal Pressure. 313 Rotatable Snares. 313 Mini-
Snares. 313 Gastroscope for Better Tip Deflection. 313 New Colonoscopes. 313 The Third-Eye Retroscope. 314 Clamshell Polyps. Retroversion. Follow-Up Interval. Polyp Size. Bleeding during Polypectomy. Polyps Too Difficult to Remove. Flat Polyps. Extremely Difficult Colonoscopy. Location of Lesions. Endoscopic Follow-Up. Healing of Polypectomy Site. Invalidity of Shaft Measurement. Endoscopic Landmarks. . Clips. Intraoperative Colonoscopy. Marker Injections into the Colon Wall. . Complications. Perforation. . Postpolypectomy Coagulation Syndrome
(Sērosi. Transmurai Burn, Postpolypectomy Syndrome),. Postpolypectomy Hemorrhage. Hot Biopsy Forceps. . Results. Checklist of Practice Points. References. 29 Dilation Techniques. Shabana F. Pasha and David E. Fleischer Introduction. Predilation Evaluation. Indications and Contraindications. . Preparation. Types of Dilator. Physiology of Esophageal Dilation. Dilation Techniques. Dilation of Peptic Strictures. . Pneumatic Dilation for Achalasia. Dilation of Schatzki Rings. Dilation of Caustic or Corrosive Strictures. . Dilation of Malignant Strictures. Self-Bougienage. Refractory and High-Grade Strictures. Complications. Conclusions.
References. 30 Endoscopic Resection, Ablation, and Dissection . Hiroyuki Ono, Stefan Seewald, and Nib Soehendra Introduction: the History of Endoscopic Treatment. Diagnosis and Indications. Pathology. New Diagnostic Technologies. Esophageal Cancer. Gastric Cancer. Colonic Cancer. Treatment Procedures. Principles. Endoscopic Mucosal Resection. Endoscopic Submucosal Dissection. Complications. Hemorrhage. Perforation. Stenosis. Ablation. Conclusions. Acknowledgments. References. 315 315 315 315 315 315 316 316 316 316 316
316 316 316 317 318 318 318 319 319 319 320 320 323 323 323 323 324 324 325 325 326 326 326 326 327 327 327 327 328 328 331 331 332 332 332 332 332 333 334 334 334 336 337 339 339 339 339 340 340 340
Contents 31 Clipping and Suturing. 343 Keiichi Ikeda and Paul Swain Introduction. Endoscopic Clipping. Endoscopic Suturing. Future Prospects. Conclusions. Disclosures. References. 343 343 344 346 346 346 346 32 Photodynamic Therapy. 349 Rami J. Badreddine and Kenneth K. Wang Introduction. Principles of PDT. Photosensitizers. PDT Light Sources for Gastrointestinal Applications. Light Dosimetry and Application Systems. Clinical Applications and Complications of PDT in the Gastrointestinal Tract. Photosensitivity. PDT in the Esophagus. PDT in the Stomach. PDT in the
Colon. PDT in the Pancreas. PDT in the Biliary Tree. Contraindications to PDT. Conclusion. References. 349 349 349 350 350 33 Endoscopic Treatment for GERD. 357 351 351 . 351 353 354 354 354 355 355 355 Byung Moo Yoo, George Triadafìlopoulos, and Glen A. Lehman Introduction. Radiofrequency Ablation. Injection/Implantation. Enteryx. Gatekeeper Reflux Repair System. Plexiglas. Endoscopic Plication Devices. EndoCinch. NDO Plicator. EsophyX. Medigus SRS Endoscopic Stapling System. Syntheon ARD Plicator. Anti-Obesity
Technique. Miscellaneous. Conclusions. References. 357 357 358 358 359 359 359 360 361 361 363 363 364 364 364 365 34 Endoscopic Papillotomy and Endoscopic Sphincterotomy. 367 Christian Prinz and Meinhard Classen Introduction. Indications. Main Duodenal Papilla and Minor Papilla. Bile Ducts. Pancreas. Admission, Premedication, and Instruments. Circumstances of Admission (In-Patient or Outpatient) Preparation. Instruments. Methods of Endoscopic Papillotomy. Biliary Papillotomy. Precut Papillotomy. Needle-Knife Papillotomy. Fistulotomy, Papillectomy (Ampullectomy). 367 367 367 367 370 372 372 372 372 375 375 375 376
378 Transpancreatic Sphincter Precutting Approach. Minor Papilla Papillotomy. Juxtapapillary Diverticula. Billroth II Gastrectomy. Rendezvous Technique. Complications of Endoscopic Papillotomy. Short-Term Complications. Long-Term Complications. Results and Outcome. Technical Success. EPT in Individual Indications. Alternatives to EPT. References. 378 379 379 380 380 380 380 383 384 384 384 387 388 35 Gastrointestinal Stenting. 393 Todd H. Baron and Richard A. Kozarek Introduction. Basic Principles. Esophageal Stenting. Placement of Esophageal SEMS. Efficacy and Complications. Self-Expanding Plastic Stents. Biodegradable
Stents. Treatment of Malignant Esophageal Fistula. Placement of Self-Expanding Stents for Benign Disease Malignant Gastric Outlet Obstruction. Gastroduodenal and Small-Bowel Self-Expanding Stents. Colonic Obstruction. Stent Types. Patient Preparation. Placement Techniques. Conclusions. References. 393 393 393 393 395 396 396 396 397 397 397 398 399 400 400 400 400 36 Biliary and Pancreatic Stenting. 403 Guido Costamagna, Pietro Familiari, and Andrea Tringali Introduction. Types of Stent. Stenting Technique. Positioning of Plastic Stents. Metal Stent Deployment. Management of Malfunctioning Stents. Plastic Stents.
SEMS. Biliary Stenting. Malignant Strictures. Benign Indications. Pancreatic Stenting. Chronic Pancreatitis. Other Pancreatic Indications. Future Developments in Biliopancreatic Stenting. Conclusions. References. 403 403 406 406 407 408 408 409 413 413 415 418 418 419 419 420 420 37 Intestinal Decompression. 425 Todd H. Baron and Faris M. Murad Introduction. Gastric and Small-Bowel Decompression. Short-Term Decompression. Long-Term Decompression. Colonic Decompression. Functional Obstruction. Mechanical Obstruction. References. 425 425 425 425 426 426 427 429 XIX
Contents 38 Approach to Gastrointestinal Foreign Bodies. 431 Benjamin K. Poulose and Jeffrey L. Ponsky Approach to the Patient with Foreign-body Ingestion . Food Bolus Impaction. Coins. Sharp Objects. Batteries and Magnets. Bezoars. Unusual Foreign Bodies. Rectal and Colonic Foreign Bodies. Surgically Assisted Endoscopic Foreign-BodyRemoval . Conclusion. References. 431 431 433 435 436 438 438 438 440 440 440 39 Biliary Lithotripsy. 443 Chan-Sup Shim Introduction. Indications. Equipment and Techniques. Peroral Cholangioscopy. Percutaneous Choledochoscopy. Mechanical Lithotripsy (ML). Shock-Wave
Lithotripsy. Electrohydraulic Lithotripsy (EHL). Laser Lithotripsy ( LL). Extracorporeal Shock-Wave Lithotripsy (ESWL). Novel Application of Direct Cholangioscopy. Results of Lithotripsy. Mechanical Lithotripsy (ML). Electrohydraulic Lithotripsy (EHL). Laser Lithotripsy (LL). Extracorporeal Shock-Wave Lithotripsy (ESWL). Complications. How to Manage Trapped Baskets. Biliary Stent Placement as an Alternative Procedure . Conclusions. References. 443 443 443 443 443 445 449 449 450 451 452 453 453 453 454 454 454 454 454 455 456 40 Percutaneous Endoscopic Gastrostomy andjejunostomy. 459 Sreeni Jonnalagadda and Steven A. Edmundowicz Introduction. Indications. Contraindications. Patient
Preparation. Procedure. Optimal PEG Site. Pull-Type (Ponsky-Gauderer) Gastrostomy. Push-Type (Sacks-Vine) Gastrostomy. Introducer-Type (Russell) Gastrostomy. Post Procedure. Endoscopically Placed Gastrojejunostomy. Direct Percutaneous Endoscopic Jejunostomy. Complications. Replacement/Removal of PEG. Conclusion. References. 41 Therapeutic Endosonography. 459 459 459 460 460 460 462 464 464 466 466 466 467 468 471 471 473 Jan-Wemer Poley and Marco J. Bruno Introduction. Equipment. EUS-Guided Celiac Plexus Neurolysis. EUS-Guided FNI in the Treatment of Pancreatic Canee՛՛ EUS-Guided Implantation of Radiopaque Markers (Fiducials). EUS-Guided Drainage of Pancreatic Fluid Collections, Abscesses, and Infected Necroses. EUS-Guided
Drainage of the Biliary System. EUS-Guided Hepaticogastrostomy. EUS-Guided Choledochoduodenostomy. EUS-Guided Cholecystostomy. EUS-Guided Pancreatic Duct Drainage and Rendezvous Future Indications for Therapeutic EUS. EUS and Vascular Interventions. EUS and NOTES. References. 473 473 473 474 475 475 479 479 480 481 481 : 83 483 483 483 VI Upper Gastrointestinal Tract Disease Section editors: Charles J. Lightdale, Hisao Tajiri, Jaques j.C.j.M. Bergman 42 Esophageal Diseases. 488 Neil Gupta and Prateek Sharma Anatomy. Mucosal Diseases. Reflux Esophagitis. Infectious Esophagitis. Pill-Induced Esophagitis. Corrosive Esophagitis. Radiation Esophagitis. Barrett’s Esophagus. Nonendoscopic Tube Trauma. Heterotopic Gastric
Mucosa. Mallory-Weiss Tears. Rings and Strictures. Schatzki Ring. Peptic Strictures. Eosinophilic Esophagitis. Diaphragmatic Hernias. Sliding Hiatal Hernias. Paraesophageal Hernias. XX 488 488 488 490 491 492 492 493 495 495 495 496 496 496 497 497 498 498 Diverticula. Zenker Diverticula. Other Esophageal Diverticula. Vascular Diseases. Varices. Arteria Lusoria. Mass Lesions of the Esophagus. Benign Tumors. Malignant Tumors. References. 498 498 499 499 499 501 501 501 503 504 43 Gastric
Diseases. 511 ¡(ristien MAJ. Tytgat and Guido N.J. Tytgat Normal Stomach-Anatomical Variants— Mucosal Prolapse and Tearing. Normal Stomach. Hiatal Hernia. Paraesophageal Hernia. Mixed Axial and Paraesophageal Herniation. Upside-Down Stomach. 511 511 512 514 514 514
Contents Gastric Diverticula. Gastroesophageal Prolapse. Mallory-Weiss Tears. Gastritis. Endoscopic Aspects. Histological Aspects. Nosological Causes of Gastric Inflammation. Infectious Gastritis. Autoimmune Gastritis. Drug-Induced Gastric Mucosal Damage. Hypertrophic-Hyperplastic Gastritis. Granulomatous Gastritis. Enterogastric or Biliary Reflux Gastritis. Physical-Chemical and Caustic Gastritis. Stress-induced Gastritis. Ischemia and Vasculitis. Miscellaneous Idiopathic Conditions. Vascular Disorders. Gastric Ulcer. Gastric Polyps. Epithelial Lesions. Subepithelial Mesenchymal Polypoid Lesions. Malignant Epithelial Tumors, Gastric Cancer. Early Gastric Cancer. Advanced Gastric Cancer. Malignant Nonepithelial
Tumors. Postoperative Stomach. References. 514 514 514 515 515 518 519 520 523 524 526 526 527 527 528 528 529 531 533 535 535 540 541 542 544 547 549 552 44 Duodenal and Small-Intestinal Diseases. 555 Blair S. Lewis Small-Bowel Tumors. Stromal Tumors. Adenoma and Adenocarcinoma. Nonneoplastic Polyps. Lipomas. Carcinoid. Lymphoma. Kaposi’s Sarcoma. Metastatic Disease. Ulcerative and Erosive Diseases of the Small Bowel Crohn’s Disease. Zollinger-Ellison Syndrome. Infections. Medication Effects. Vasculitis. Radiation Injury. Mesenteric Ischemia. Graft-versus-Host Disease (GVHD). Congenital Lesions.
555 557 557 558 558 559 559 560 560 560 560 560 561 561 561 562 562 562 563 Diverticula and Duplication Cysts. Meckel’s Diverticulum. Duplication Cysts. Vascular Anomalies. Malabsorption. Celiac Disease. Whipple’s Disease. Amyloid. References. 563 563 564 564 567 567 567 568 568 45 Diseases of the Ampulla. 571 Nalini M. Guda and Joseph E. Geenen Introduction. Anatomic Variations. Papillitis. Tumors of the Ampulla of Vater. Periampullary Fistula. Sphincter of Oddi Dysfunction. Diseases of the Minor Papilla.
References. 571 571 572 573 574 574 575 575 46 Upper Gastrointestinal Bleeding Disorders. 577 Shiv K. Sarin, Vikram Bhatia, Justin C.Y. Wu, and Joseph J.Y. Sung Variceal Bleeding in Cirrhosis. 577 Shiv K. Sarin and Vikram Bhatia Anatomy of Esophageal and Gastric Varices. 577 Classification Systems. 577 Local and Systemic Hemodynamics. 577 Predictors of First Variceal Bleed. 578 Natural History. 579 Treatment of Acute Esophageal Variceal Hemorrhage. 580 Treatment of Acute Gastric Variceal Hemorrhage. 583 Prophylaxis. 586 Nonvariceal Upper Gastrointestinal Bleeding. 587 Justin C.Y. Wu and Joseph J.Y. Sung Introduction. 587 Preendoscopy Management. 587 Peptic Ulcer. 588 Gastric and Duodenal Erosion and Hemorrhage. 589 Mallory-Weiss Syndrome. 589 Esophagitis and Esophageal Ulcers. 589 Dieulafoy Lesion.
590 Gastric Antral Vascular Ectasia. 590 Upper Gastrointestinal Tumors. 591 Other Rare Causes of Nonvariceal Upper Gastrointestinal Bleeding. 591 References. 591 VII Lower Gastrointestinal Tract Diseases Section editors: Charles ]. Lightdale, Guido N.j. Tytgat, Alexander Meining 47 Colorectal Disorders. 596 Witold Bartnik, Jacek Pachlewski, and Jarosław Regula Colorectal Polyps. Hereditary Colorectal Syndromes. Colorectal Cancer. Ischemic Colitis. Pseudomembranous Colitis. Bacterial Colitis. Tuberculosis. 596 602 604 606 606 607 608 Viral Colitis. Diverticular Disease. Microscopic Colitis. Drug-Induced and Chemical-Induced Colopathy. Melanosis
Coli. Pneumatosis Cystoides Intestinalis. Solitary Rectal Ulcer Syndrome. Colitis Cystica Profunda. 609 609 610 611 611 612 612 613 XXI
Contents Stercoral Ulcers. Lipomas. Large-Bowel Carcinoids. Colonic Endometriosis. Metastases to the Large Bowel. Other Diseases. References. 613 613 613 614 614 614 614 48 Endoscopy of Inflammatory Bowel Disease. Wojciech Błoński, David Kotlyar, and Gary R. Lichtenstein Introduction. Preparation for Colonoscopy. Endoscopic Evaluation of Disease Activity. Ulcerative Colitis. Crohn’s Disease. Endoscopic Characteristics of IBD. Colonoscopy. Complications. Normal Colonic Mucosa. Ulcerative Colitis. Crohn’s Disease. Upper
Endoscopy. Ulcerative Colitis. Crohn’s Disease. Surgery for IBD. Pouchitis. Postoperative Recurrence of Crohn’s Disease. Complications of Crohn’s Disease. Strictures. Acute Lower Gastrointestinal Bleeding. Differentia] Diagnosis. Cancer and IBD. Risk of Colorectal Cancer. Dysplasia. Endoscopic Surveillance. Endoscopic Features Associated with Dysplasia. Endoscopic Detection of Colonic Neoplasia. Capsule Endoscopy. Enteroscopy. Push Enteroscopy. Double-Balloon Enteroscopy. Perioperative Endoscopy. Endoscopic Retrograde
Cholangiopancreatography. Endoscopic Ultrasonography (EUS). Conclusions. Acknowledgment. References. 617 617 617 617 617 618 620 620 620 620 620 622 625 625 625 626 626 626 627 627 627 627 630 630 630 630 632 632 634 634 634 634 635 636 636 636 637 637 49 Lower Intestinal Bleeding Disorders. Juergen Bamert and Helmut Messmann Definitions. General Aspects. Epidemiology. Clinical Course and Prognosis. Diagnostic Approach. History. Physical Examination. Laboratory Studies. Endoscopy. Nonendoscopic Methods. Differential Diagnosis. Colon. Small
Bowel. Therapy. Initial Resuscitation. Endoscopy. Radiologic Angiotherapy. Surgery. Pharmacotherapy. Differential Endoscopic Therapy. Impact of Endoscopy on the Outcome. References. 50 Anorectal Disease. Joep F.W.M. Bartelsman Proctitis. Infectious Proctitis. Gonorrhea. Chlamydial Infection. Syphilis. Herpes Simplex Virus (HSV). CMV Infection. Ischemic Proctitis. Radiation Proctitis. Solitary Rectal Ulcer Syndrome. Anal
Fissure. Hemorrhoids. Rectal Prolapse. Condylomata Acuminata (Genital Warts). Anal Cancer. Anal Intraepithelial Neoplasia. References. 641 641 641 641 641 641 641 641 642 642 644 645 645 548 050 450 550 551 651 551 552 63 54 59 659 559 559 459 060 60 360 360 360 3352 363 563 64 65 '565 566 567 Vlil Blliopancreatic, Hepatic, and Peritoneal Diseases Section editors: Charles ]. Lightdale, Meinhard Classen, D. Nageshwar Reddy 51 Biliary Tract Diseases. Nathan J. Shores and John Baillie Introduction. Procedures. General Indications for ERCP and EUS. Antibiotic Coverage. Contrast Allergy. Difficult Anatomy. The Normal Cholangiogram. Cholelithiasis.
Choledocholithiasis. 670 670 670 670 670 671 671 671 672 673 Background. ERCP, EUS, or MRCP to Diagnose Choledocholithiasis?. Endoscopic Management. Gallbladder Lesions. Biliary Malignancy. Malignancy Affecting the Biliary Tree. A Potpourri of Imaging Techniques. EUS or ERCP in the Diagnosis of Biliary Malignancy. Tissue Sampling. Staging of Bile Duct Tumors. Biliary Stenting. 673 673 674 679 680 680 680 680 681 682 682
Contents Miscellaneous Conditions in the Biliary Tree. Primary Sclerosing Cholangitis. Choledochal Cysts. Sphincter of Oddi Dysfunction. Biliary Parasites. Some Recent Developments. References. 682 682 684 685 687 687 688 52 Pancreatic Disease. Evan L Fogel, Furquaan Ahmed, and Stuart Sherman Introduction. Developmental Anomalies of the Pancreas. Pancreas Divisum: Diagnosis and Therapy. Annular Pancreas. Pancreatic Agenesis. Anomalous Pancreaticobiliary Ductal Junction. Acute Pancreatitis. Acute Gallstone Pancreatitis. Acute Recurrent Pancreatitis of Known or Unknown Cause. Unresolving Acute Pancreatitis. Chronic Pancreatitis. Pancreatic Strictures. Pancreatic
Ductal Stones. Pancreatic Pseudocysts and Fistulas. Biliary Obstruction in Chronic Pancreatitis. 693 693 693 693 700 701 701 702 702 704 705 707 707 709 712 714 Autoimmune Pancreatitis. Sphincter of Oddi Dysfunction. Pancreatic Neoplasms . Conclusions. References. 715 715 716 719 719 53 Diseases of the Liver and Peritoneum. H.Juergen Nord Introduction. Diseases of the Liver and Biliary System. Normal Findings. Fatty Liver. Acute and Chronic Hepatitis. Focal Liver Lesions. Benign Focal Lesions. Focal Malignant Lesions. Peritoneal Disorders. Primary Peritoneal Disease. Metastatic Disease. Infectious
Diseases. Ascites of Unknown Cause. Perihepatitis. Chronic and Acute Pain Syndromes. Acute Abdomen, Blunt Abdominal Trauma. References. 723 723 723 723 724 725 729 729 731 734 734 735 736 736 736 736 737 737 IX Infectious Diseases of the Gastrointestinal Tract Section editors: Cuido N.J. Tytgat, Charles J. Lightdale, Michael B. Wallace 54 Infectious Diseases of the Intestines. Paul Feuerstadt and Lawrence J. Brandt Introduction. Clinical Features. History. Physical Examination. Diagnostic Testing. Differentiating Infectious Colitis from Inflammatory Bowel Disease. Treatment. Specific Organisms. Viruses. Bacteria. Parasitic
Diseases. References. 55 Intestinal Abnormalities in AIDS. Andrew T. Pellecchia and Lawrence J. Brandt Introduction. Dysphagia and Odynophagia. Etiology. Candida Esophagitis. Cytomegalovirus. 742 742 742 742 742 742 743 744 745 745 745 748 750 753 753 753 753 754 754 Herpes Simplex Virus. Idiopathic (Aphthous) Ulcers. Other. Abdominal Pain. Gastric Diseases. Cytomegalovirus. Kaposi’s Sarcoma. Lymphoma. Mycobacterium avium complex (MAC). Pancreaticobiliary Diseases. Pancreatitis. Acalculous
Cholecystitis. AIDS Cholangiopathy. Diarrhea. Pathogens. Diagnostic Yield. Specific Pathogens and Endoscopic Appearance. Gastrointestinal Bleeding. AIDS-Related Upper Gastrointestinal Bleeding. AIDS-Related Lower Gastrointestinal Bleeding. AIDS and the Endoscopist. Conclusions. References. 754 754 754 755 755 755 755 756 756 756 756 756 757 757 757 758 759 760 760 760 761 761 761
Contents X Pediatric Endoscopy Section editors: Guido N.J. Tytgat, Charles J. Lightdale, Meinhard Classen 56 Pediatric Endoscopy. 766 Victor L Fox XXIV Introduction. Patient Preparation. Emotional Preparation. Dietary Restrictions. Sedation. Antibiotic Prophylaxis. Contraindications. Equipment. Upper Gastrointestinal Endoscopy. Indications and Specific Diagnostic and Therapeutic Applications. Enteroscopy. Colonoscopy. Bowel Preparation. Equipment. 766 766 766 767 767 769 769 769 769 770 782 783 783 784 Index. 806 Basic Technique.
Polypectomy. Indications and Contraindications. Specific Diagnostic and Therapeutic Applications. Endoscopic Retrograde Cholangiopancreatography. Introduction. Equipment. Patient Preparation and Sedation. Basic Technique. Role of the Pediatric Endoscopist. Contraindications. Diagnostic and Therapeutic Indications. Biliary Conditions. Pancreatic Conditions. Gastrointestinal Endosonography. References. 784 784 785 786 789 789 790 790 790 790 790 790 791 796 798 801 |
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| genre | (DE-588)4143303-8 Atlas gnd-content |
| genre_facet | Atlas |
| id | DE-604.BV047457950 |
| illustrated | Illustrated |
| index_date | 2024-07-03T18:05:19Z |
| indexdate | 2024-07-10T09:12:41Z |
| institution | BVB |
| isbn | 9783131258526 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-032859785 |
| oclc_num | 845563352 |
| open_access_boolean | |
| owner | DE-384 |
| owner_facet | DE-384 |
| physical | XXVII, 824 Seiten Illustrationen, Diagramme 31 cm |
| publishDate | 2010 |
| publishDateSearch | 2010 |
| publishDateSort | 2010 |
| publisher | Thieme |
| record_format | marc |
| spelling | Gastroenterological endoscopy Meinhard Classen, Guido N.J. Tytgat, Charles J. Lightdale ; Associate editors Jacques J. G. J. M. Bergman [und vier weitere] ; with contributions by Douglas G. Adler [und viele weitere] Second edition Stuttgart ; New York, NY Thieme [2010] XXVII, 824 Seiten Illustrationen, Diagramme 31 cm txt rdacontent n rdamedia nc rdacarrier Literaturangaben Gastroenterologische Endoskopie (DE-588)4019404-8 gnd rswk-swf (DE-588)4143303-8 Atlas gnd-content Gastroenterologische Endoskopie (DE-588)4019404-8 s DE-604 Classen, Meinhard 1936-2019 (DE-588)115745696 edt Adler, Douglas G. (DE-588)140308474 ctb Tytgat, Guido N. J. (DE-588)136452884 edt Digitalisierung UB Augsburg - ADAM Catalogue Enrichment application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=032859785&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Gastroenterological endoscopy Gastroenterologische Endoskopie (DE-588)4019404-8 gnd |
| subject_GND | (DE-588)4019404-8 (DE-588)4143303-8 |
| title | Gastroenterological endoscopy |
| title_auth | Gastroenterological endoscopy |
| title_exact_search | Gastroenterological endoscopy |
| title_exact_search_txtP | Gastroenterological endoscopy |
| title_full | Gastroenterological endoscopy Meinhard Classen, Guido N.J. Tytgat, Charles J. Lightdale ; Associate editors Jacques J. G. J. M. Bergman [und vier weitere] ; with contributions by Douglas G. Adler [und viele weitere] |
| title_fullStr | Gastroenterological endoscopy Meinhard Classen, Guido N.J. Tytgat, Charles J. Lightdale ; Associate editors Jacques J. G. J. M. Bergman [und vier weitere] ; with contributions by Douglas G. Adler [und viele weitere] |
| title_full_unstemmed | Gastroenterological endoscopy Meinhard Classen, Guido N.J. Tytgat, Charles J. Lightdale ; Associate editors Jacques J. G. J. M. Bergman [und vier weitere] ; with contributions by Douglas G. Adler [und viele weitere] |
| title_short | Gastroenterological endoscopy |
| title_sort | gastroenterological endoscopy |
| topic | Gastroenterologische Endoskopie (DE-588)4019404-8 gnd |
| topic_facet | Gastroenterologische Endoskopie Atlas |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=032859785&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| work_keys_str_mv | AT classenmeinhard gastroenterologicalendoscopy AT adlerdouglasg gastroenterologicalendoscopy AT tytgatguidonj gastroenterologicalendoscopy |