Appendix Subject Index

Systematic Endoscopic Examination - 184

Characterization of Abnormal Findings - 186

An endoscopic examination should be conducted according to a systematic routine. At each point during the examination, the endoscopist should clearly understand what he or she is doing and what he or she is seeing. The sequence of the individual steps will vary somewhat from one examiner to the next, but it is essential to adopt a systematic routine.

The outline below is intended as a practical guide for conducting a systematic endoscopic examination.

Esophagus

Upper esophageal sphincter

2. Midesophageal constriction

- Right main bronchus

- Aorta

- Spinal column

3. Retrocardial esophagus

4. Sphincter function

- Shape

- Location in centimeters from the incisors

6. Diaphragmatic hiatus in centimeters from the incisors

Endoscopic evaluation

- Color

- Surface

- Symmetry

- Indentations

- Secretions

► Peristalsis

- Frequency

- Propulsion

- Symmetry

Stomach

Cardia in forward view

2. Body of stomach

- Greater curvature

- Lesser curvature

- Anterior wall

- Posterior wall

- Rugal folds

3. Antrum

- Antral peristalsis

- Symmetry

4. Pylorus

- Shape

- Function

5. Angulus

6. Fundus

7. Cardia in retroflexed view, 360°

Endoscopic evaluation

- Gastric juice

- Food residues

- Mucus

- Color

- Surface

► Identification of adjacent structures

- Liver

- Pancreas

- Spleen

- Heart

- Duodenum

► Peristalsis

Duodenum

1. Bulb

- Anterior wall

- Posterior wall

- Lesser curvature

- Greater curvature

2. Descending duodenum

- Valvulae conniventes

- Papilla

Endoscopic evaluation

- Bulb: ulcer niche?

- Color

- Surface

Orientation in the Gastric Body

Anterior wall

Esophagus

► Location in centimeters from the incisors

► Longitudinal extent

► Circumferential extent

► Relation to physiological constrictions

Duodenal Bulb and Descending Duodenum

► Duodenal bulb

- Anterior wall

- Posterior wall

- Greater curvature

- Lesser curvature

► Descending duodenum

► Relation to papilla

Orientation in the Gastric Body

Anterior wall

Lesser curvature

Stomach

- Anterior wall

- Posterior wall

- Greater curvature

- Lesser curvature Antrum

- Angulus

- Prepyloric antrum

- Intrapyloric

Orientation in the Duodenal Bulb

Lesser curvature

Orientation in the Duodenal Bulb

Lesser curvature

Anterior wall

Anterior wall

Posterior wall

Greater curvature

Posterior wall

Greater curvature

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