43247 Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)

Name of the Procedure:

Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)
Common Name: Upper GI Endoscopy with Foreign Body Removal

Summary

An upper GI endoscopy is a procedure in which a flexible tube with a camera (endoscope) is inserted through the mouth to inspect the esophagus, stomach, and the beginning of the small intestine. This particular procedure includes the removal of any foreign objects that may be lodged in these areas.

Purpose

This procedure is used to diagnose and treat conditions that affect the upper digestive tract. The goal is to visually inspect these areas and remove any foreign bodies that may be causing symptoms or obstructing the digestive process.

Indications

• Swallowed objects that are causing pain or obstruction
• Symptoms like difficulty swallowing, vomiting, or abdominal pain
• Suspected ingestion of corrosive or harmful substances
• X-ray or imaging findings indicating a foreign body

Preparation

• Fasting for at least 6-8 hours before the procedure to ensure an empty stomach
• Temporary discontinuation of certain medications, as advised by the doctor
• Blood tests or imaging studies may be required to evaluate the location and nature of the foreign object

Procedure Description

1. Patient receives a local anesthetic to numb the throat and is sedated to ensure comfort.
2. A flexible endoscope is gently inserted through the mouth and guided down the esophagus, into the stomach, and the duodenum.
3. The camera transmits images to a monitor, allowing the doctor to navigate and identify the foreign object.
4. Special instruments passed through the endoscope are used to grasp and remove the object.
5. The endoscope is then carefully withdrawn, and the patient is monitored as they recover from the sedation.

Duration

The procedure typically takes about 15-30 minutes, though it can vary depending on the complexity of the case.

Setting

Performed in a hospital, outpatient clinic, or surgical center equipped with endoscopic facilities.

Personnel

• Gastroenterologist or surgeon specializing in endoscopic procedures
• Nurses and support staff for preparation and monitoring
• Anesthesiologist or nurse anesthetist to administer sedation

Risks and Complications

• Mild sore throat post-procedure
• Bleeding, particularly if the foreign object caused trauma
• Perforation or tearing of the esophagus, stomach, or duodenum (rare)
• Adverse reactions to sedation

Benefits

• Immediate relief from obstruction or discomfort caused by the foreign object
• Prevention of further complications like infection or perforation
• Diagnostic insights into any underlying conditions causing symptoms

Recovery

• Patients are observed for a short period after the procedure to ensure full recovery from sedation.
• Instructions include avoiding solid food for a few hours and adhering to any specific dietary guidelines.
• Return to normal activities typically within 24 hours, unless otherwise advised.
• Follow-up visits to monitor recovery and ensure no complications.

Alternatives

• Observation and waiting, if the foreign object is small and expected to pass naturally
• Radiologic removal techniques guided by imaging
• Surgical intervention if endoscopic removal is not feasible

Patient Experience

During the procedure, patients are usually sedated and unlikely to feel discomfort. Post-procedure, the throat may feel sore, and mild bloating can occur. Pain management and comfort measures, such as throat lozenges and soft foods, can help mitigate these symptoms.