[Transnasal esophagogastroduodenoscopy?].

INTRODUCTION

The most proper examination for the morphological changes of the upper gastrointestinal tract is endoscopy. The standard oro-gastric route is carried out under conscious sedation, but the drugs used might have cardiopulmonary side effects. Furthermore there are a few conditions when this routine endoscopy is technically impossible.

AIMS: Could these failures be avoided with an endoscope led through the nose? Are there advantages of the use of ultrathin endoscopes for transnasal oesophago-gastro-duodenoscopy?

PATIENTS/

METHODS

Own experiences with transnasal therapeutic endoscopies on patients with cancer in the head and neck region compared with data from the literature.

RESULTS

Based on literature and on own experiences, transnasal oesophago-gastro-duodenoscopy may be advised in cases with trismus, stenosis of the upper aero-digestive tract, oropharyngeal dysphagia, cricopharyngeal achalasia, in several neurosurgical conditions and on severely ill ventilated patients. I.v. premedication is not always necessary for transnasal oesophago-gastro-duodenoscopy done with ultrathin endoscopes.

CONCLUSIONS

The oesophagus might be accessed also via the nose, but it must be emphasized that transnasal oesophago-gastro-duodenoscopy is only advised when the standard way of upper gastrointestinal tract endoscopy is impossible.