Name of the Procedure:

Esophagogastroduodenoscopy (EGD), flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (e.g., anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination).

Summary

An Esophagogastroduodenoscopy (EGD) is a procedure where a flexible tube with a camera is inserted through the mouth to examine the esophagus, stomach, and initial part of the small intestine. When performed with an endoscopic ultrasound (EUS), it uses high-frequency sound waves to create detailed images of the digestive tract. This specific procedure also includes the injection of substances or markers for diagnostic or therapeutic purposes.

Purpose

This procedure is used to diagnose and treat problems within the upper gastrointestinal tract. It might be used to assess pain, inflammation, and other issues, or to deliver treatment directly to affected areas.

Indications

• Persistent upper abdominal pain
• Difficulty swallowing
• Gastrointestinal bleeding
• Evaluation of tumors or masses
• Chronic gastrointestinal conditions (e.g., Crohn's disease)

Preparation

• Fasting: Patients should not eat or drink at least 6 hours before the procedure.
• Medication Adjustments: Patients may need to stop certain medications (e.g., blood thinners).
• Diagnostics: Blood tests and imaging studies may be required.

Procedure Description

1. The patient is sedated or given anesthesia.
2. A flexible tube with a camera (endoscope) is inserted through the mouth.
3. Using the endoscope, the doctor inspects the esophagus, stomach, and duodenum.
4. An endoscopic ultrasound probe is used to create detailed images.
5. The doctor can inject diagnostic or therapeutic substances (e.g., anesthetic, neurolytic agent) or fiducial markers through the endoscope.
6. Additional biopsies or interventions can be performed as needed.

Duration

The procedure typically takes about 30-60 minutes.

Setting

It is usually performed in a hospital or an outpatient surgical center.

Personnel

• Gastroenterologist or surgeon
• Anesthesiologist
• Nurses and technologists

Risks and Complications

• Sore throat
• Bleeding
• Perforation of the gastrointestinal tract
• Adverse reaction to sedation
• Infection

Benefits

• Accurate diagnosis of gastrointestinal issues
• Targeted treatment delivery
• Minimal invasiveness compared to open surgery
• Rapid symptom relief

Recovery

• Patients typically stay under observation for a few hours post-procedure.
• Needs to arrange transportation due to sedation.
• Avoid eating or drinking until the gag reflex returns.
• Follow-up appointment for results and further management.

Alternatives

• Non-invasive imaging tests (e.g., MRI, CT scans)
• Open or laparoscopic surgery
• Symptomatic drug treatments

Patient Experience

During the procedure, patients are usually sedated, so they shouldn’t feel any pain. Some may experience mild discomfort or a sore throat afterward. Sedatives will necessitate a recovery period and assistance with transportation. Pain and discomfort are managed with medications.