Department of Endoscopy

• X-ray examination did not show that a patient has any diseases of the upper digestive tract;
• X-ray examination provided uncertain data on changes, in particular, if tumor is suspected;
• a patient has a stomach ulcer with a view to finding out whether it is malignant or not;
• a patient has a benign tumor, in particular, polyps with a view to deciding on endoscopic polypectomy;
• a patient has peptic and duodenal ulcer disease with a view to monitoring the dynamics during conservative treatment;
• a patient has events of jaundice, and usual methods of examination cannot define the character of the disease;
• a patient has cancerophobia, anemia or fever of unknown cause;
• patients with foreign bodies of intestine, stomach or duodenum;
• a patient needs therapeutic endoscopy;
• a patient has signs of gastrointestinal bleeding.

Absolute contraindications to esophagogastroduodenoscopy:

• cardiopulmonary decompensation;
• acute myocardial infarction or stroke;
• hemophilia.

Relative contraindications to esophagogastroduodenoscopy:

• cardiopulmonary failure;
• aortic aneurysm;
• large goiter;
• stage III hypertension;
• stenocardia;
• angina pectoris;
• mental diseases;
• acute inflammatory diseases of tonsils, larynx or pharynx;
• exacerbation of chronic bronchitis;
• pronounced curvature of the thoracic spine and cervical osteochondrosis;
• late pregnancy;
• active tuberculosis.

How to prepare for esophagogastroduodenoscopy:

• fast (if you are going to have the examination after 2.00pm, you may have a light breakfast);
• lavage the stomach overnight, if you have problems with emptying your stomach;
• start taking antihistamine drugs 1 or 2 days before the procedure, if you have allergy, or tranquilizers, if you are anxious about the procedure.

Indications for colonofiberscopy:

• clinical picture of balstomatoid lesion of the large intestine with negative or uncertain results of X-ray examinations;
• single and multiple polyps of the large intestine;
• history of radical surgery for malignant tumors of the large intestine;
• nonspecific ulcerative colitis and Crohn’s disease;
• events of bleeding from lower digestive tract.

Contraindications to colonofiberscopy:

• severe nonspecific ulcerative colitis and Crohn’s disease;
• cardiopulmonary decompensation;
• acute myocardial infarction or stroke;
• pregnancy;
• adhesion in the abdominal cavity.

How to prepare for colonofiberscopy:

Keep to an easily digestible diet for 2 or 3 days before the procedure or fast for 1 or 2 days. Take 30.0 ml of castor oil or 25.0 ml of magnesium sulfate at 4.00pm the day before the procedure (laxatives shall not be prescribed to the patients with diarrhea). Make 1 or 2 cleansing enemas 1.5 or 2 hours before the examination.

RCP is the examination of bile and pancreatic ducts with the help of a duodenoscope. The ampulla of Vater is catheterized, water-soluble contrast agent is injected through the probe and X-ray images are made.

Indications for RCP:

• jaundice, when usual methods of examination cannot define the character of the disease;
• obstructive jaundice with a view to determining the cause of the disease and assess the state of the bile ducts;
• pain syndrome, remittent jaundice, signs of cholangitis or chronic pancreatitis after cholecystectomy;
• cholecystitis (not acute), when the results of contrast-based X-ray examinations of bile ducts and gall bladder are uncertain or negative;
• suspected pancreatic cyst or tumor;
• clinical picture of choric pancreatitis with a view to specifying the diagnosis.

The contraindications to RCP are the same as to gastroscopy + acute pancreatitis and intolerance to contrast media. The preparation for RCP is the same as for esophagogastroduodenoscopy.