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Name
Endoscopy
Short Description
Endoscopy, gastrointestinal endoscopy
Affected Animals: Patients with disorders of the esophagus, stomach, or intestines
may be candidates for endoscopy.
Overview: The term endoscopy refers to evaluation of the
gastrointestinal tract for the presence of a wide variety of
esophageal, stomach, and intestinal disorders. An endoscopy requires
specialized equipment, and the veterinarian performing it must have
training and expertise in the procedure.
In addition to its use as a diagnostic tool, endoscopy also has
therapeutic applications. The procedure can be used to remove
foreign objects from the esophagus and the stomach, to place feeding
tubes into the stomach without the need for surgery, and to correct
strictures, which are narrowed areas in the esophagus or colon
resulting from scar tissue formation.
Endoscopy does require general anesthesia.
Complications related to endoscopy are uncommon, and the procedure
is non-invasive.
Description:
In small animals, endoscopy is performed under general anesthesia
with a flexible, fiberoptic endoscope. The endoscope is attached to
a light source, and a lens allows visualization of the areas being
examined. It is often hooked up to a video camera so that the
examination can be recorded. The endoscope has small channels
through which biopsy forceps or retrieving instruments can be
passed. Water and air can be sent through separate channels to keep
the viewing area clean, and to allow for distension of the portions
of the gastrointestinal tract as they are examined. Rigid endoscopes
are also available, and can be very useful for evaluation of the
esophagus and the lower parts of the intestinal tract. Prior to
endoscopy, initial diagnostics usually include a thorough physical
examination, bloodwork, and x-rays. Fecal examinations for
parasites, stool cultures, and abdominal ultrasound are additional
tests that may need to be considered prior to endoscopy.
Once the patient is anesthetized, the endoscope is passed into the
mouth and then into the esophagus, stomach, and small intestine for
the examination of the upper part or the gastrointestinal tract.
Each area is carefully inspected for abnormalities that are apparent
to the naked eye. Biopsies are taken from areas that appear
abnormal, but also from areas that look normal since, in many cases,
diseases are found on biopsy in tissues that look normal on
endoscopy.
For colonoscopy, the endoscope is passed into the anus, then into
the rectum, and up into the colon. The entire length of the colon
can be examined, all the way to the point where the small intestine
empties into the large intestine. In some circumstances, it is
possible to pass the endoscope into the ileum, the last part of the
small intestine, allowing for evaluation of that portion of the
intestinal tract as well. If colonoscopy is done along with
examination of the upper part of the gastrointestinal tract, this
part of the procedure is done last.
Prognosis: The prognosis depends upon the diagnosis
determined by the procedure. Serious complications related to
endoscopy itself are rare. Anesthetic complications can occur, but
these are also relatively uncommon.
Patients with a high likelihood of complications, and those that are
extremely unstable should not undergo endoscopy unless it is felt
that the procedure is necessary for therapeutic intervention. If
portions of the gastrointestinal tract are especially devitalized
due to injury or disease, rupture can occur once they are distended
with air. Large ulcer craters can be perforated at the time of
endoscopy, and this can lead to peritonitis.
Pre procedure Care:
Fasting from food is usually advised prior to
endoscopy. A 12-hour fast is usually adequate prior to examination
of the upper gastrointestinal tract, but in some animals, normal
stomach emptying time can be as long as 16 hours after the patient's
last meal. In addition, animals suspected of having problems with
delayed stomach emptying might need to fast for 18 to 24 hours. For
colonoscopy, fasting may be extended for 24 to 36 hours. Additional
preparation required prior to colonoscopy can include the oral
administration of specific medications or special solutions to help
cleanse the colon prior to the procedure. Enemas may be used to
accomplish the same goal. It may be difficult to do a thorough
examination if there is an excessive amount of fecal material in the
colon at the time of the procedure.
Post procedure Care: The care of the patient after endoscopy depends
on the animal's condition prior to the procedure. Stable patients
undergoing endoscopy for diagnostic purposes can usually be released
after they recover completely from anesthesia. The animals should be
monitored, especially around stairs and furniture, until it is
certain that recovery is complete. Small amounts of food and water
can be offered the evening after the procedure and normal amounts
may be given the following day. Patients that are ill enough to
require hospitalization, or those that recover slowly from
anesthesia, are managed by the veterinarian in the hospital until
their condition is adequate for release. There is no healing time
associated with endoscopy, which is one of the advantages it has
over surgery.
