Yield of routine endoscopy beyond the duodenal bulb

Thomas G. Morales, Philip E. Jaffe, M (Brian) Fennerty, Richard E. Sampliner

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The authors determined the clinical yield, endoscopic time, and patient tolerance of routine upper endoscopy beyond the duodenal bulb. From May through October 1994, all patterns undergoing routine esophagogastroduodenoscopy (EGD) were recruited for study. Each procedure was timed from start to finish by the endoscopy nurse, and, in addition, the time of the postbulbar examination was recorded. The endoscopy nurse assessed the patient's comfort level when the endoscope was advanced into the duodenal bulb and again at the postbulbar region. A total of 250 EGDs were performed. There were 152 males and 98 females, with a mean age of 57.1 (range, 23-91) years. Indications for the procedure were as follows: gastroesophageal reflux disease symptoms 82, epigastric pain 64, dysphagia 46, Barrett's surveillance 25, anemia 23, other research study 16, and other 61. The mean time for the procedure was 11 rain and 54 s, whereas the mean time for the postbulbar examination was 46.6 s. Patients tolerated endoscope insertion well both before and during examination of the postbulbar duodenum. The only postbulbar finding that affected clinical management was a postbulbar ulcer in a patient without other ulcers who was positive for Helicobacter pylori. Although routine endoscopic examination beyond the duodenal bulb involves minimal time and is well tolerated by patients, the yield of pathologic findings is low (3.6%) and the yield of findings that alter clinical management even lower (0.4%). In patients without prior GI surgery undergoing routine EGD for indications other than suspected small bowel pathology or active upper GI bleeding, examination of the postbulbar duodenum can be considered an elective part of the procedure.

Original languageEnglish (US)
Pages (from-to)147-149
Number of pages3
JournalJournal of Clinical Gastroenterology
Volume24
Issue number3
DOIs
StatePublished - Apr 1997
Externally publishedYes

Fingerprint

Endoscopy
Digestive System Endoscopy
Endoscopes
Duodenum
Ulcer
Nurses
Rain
Deglutition Disorders
Gastroesophageal Reflux
Helicobacter pylori
Anemia
Pathology
Hemorrhage
Pain
Research

Keywords

  • Endoscopy
  • Patient tolerance
  • Postbulbar duodenum

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Yield of routine endoscopy beyond the duodenal bulb. / Morales, Thomas G.; Jaffe, Philip E.; Fennerty, M (Brian); Sampliner, Richard E.

In: Journal of Clinical Gastroenterology, Vol. 24, No. 3, 04.1997, p. 147-149.

Research output: Contribution to journalArticle

Morales, Thomas G. ; Jaffe, Philip E. ; Fennerty, M (Brian) ; Sampliner, Richard E. / Yield of routine endoscopy beyond the duodenal bulb. In: Journal of Clinical Gastroenterology. 1997 ; Vol. 24, No. 3. pp. 147-149.
@article{7408e929551e4263baa6a56ab154ed7d,
title = "Yield of routine endoscopy beyond the duodenal bulb",
abstract = "The authors determined the clinical yield, endoscopic time, and patient tolerance of routine upper endoscopy beyond the duodenal bulb. From May through October 1994, all patterns undergoing routine esophagogastroduodenoscopy (EGD) were recruited for study. Each procedure was timed from start to finish by the endoscopy nurse, and, in addition, the time of the postbulbar examination was recorded. The endoscopy nurse assessed the patient's comfort level when the endoscope was advanced into the duodenal bulb and again at the postbulbar region. A total of 250 EGDs were performed. There were 152 males and 98 females, with a mean age of 57.1 (range, 23-91) years. Indications for the procedure were as follows: gastroesophageal reflux disease symptoms 82, epigastric pain 64, dysphagia 46, Barrett's surveillance 25, anemia 23, other research study 16, and other 61. The mean time for the procedure was 11 rain and 54 s, whereas the mean time for the postbulbar examination was 46.6 s. Patients tolerated endoscope insertion well both before and during examination of the postbulbar duodenum. The only postbulbar finding that affected clinical management was a postbulbar ulcer in a patient without other ulcers who was positive for Helicobacter pylori. Although routine endoscopic examination beyond the duodenal bulb involves minimal time and is well tolerated by patients, the yield of pathologic findings is low (3.6{\%}) and the yield of findings that alter clinical management even lower (0.4{\%}). In patients without prior GI surgery undergoing routine EGD for indications other than suspected small bowel pathology or active upper GI bleeding, examination of the postbulbar duodenum can be considered an elective part of the procedure.",
keywords = "Endoscopy, Patient tolerance, Postbulbar duodenum",
author = "Morales, {Thomas G.} and Jaffe, {Philip E.} and Fennerty, {M (Brian)} and Sampliner, {Richard E.}",
year = "1997",
month = "4",
doi = "10.1097/00004836-199704000-00005",
language = "English (US)",
volume = "24",
pages = "147--149",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Yield of routine endoscopy beyond the duodenal bulb

AU - Morales, Thomas G.

AU - Jaffe, Philip E.

AU - Fennerty, M (Brian)

AU - Sampliner, Richard E.

PY - 1997/4

Y1 - 1997/4

N2 - The authors determined the clinical yield, endoscopic time, and patient tolerance of routine upper endoscopy beyond the duodenal bulb. From May through October 1994, all patterns undergoing routine esophagogastroduodenoscopy (EGD) were recruited for study. Each procedure was timed from start to finish by the endoscopy nurse, and, in addition, the time of the postbulbar examination was recorded. The endoscopy nurse assessed the patient's comfort level when the endoscope was advanced into the duodenal bulb and again at the postbulbar region. A total of 250 EGDs were performed. There were 152 males and 98 females, with a mean age of 57.1 (range, 23-91) years. Indications for the procedure were as follows: gastroesophageal reflux disease symptoms 82, epigastric pain 64, dysphagia 46, Barrett's surveillance 25, anemia 23, other research study 16, and other 61. The mean time for the procedure was 11 rain and 54 s, whereas the mean time for the postbulbar examination was 46.6 s. Patients tolerated endoscope insertion well both before and during examination of the postbulbar duodenum. The only postbulbar finding that affected clinical management was a postbulbar ulcer in a patient without other ulcers who was positive for Helicobacter pylori. Although routine endoscopic examination beyond the duodenal bulb involves minimal time and is well tolerated by patients, the yield of pathologic findings is low (3.6%) and the yield of findings that alter clinical management even lower (0.4%). In patients without prior GI surgery undergoing routine EGD for indications other than suspected small bowel pathology or active upper GI bleeding, examination of the postbulbar duodenum can be considered an elective part of the procedure.

AB - The authors determined the clinical yield, endoscopic time, and patient tolerance of routine upper endoscopy beyond the duodenal bulb. From May through October 1994, all patterns undergoing routine esophagogastroduodenoscopy (EGD) were recruited for study. Each procedure was timed from start to finish by the endoscopy nurse, and, in addition, the time of the postbulbar examination was recorded. The endoscopy nurse assessed the patient's comfort level when the endoscope was advanced into the duodenal bulb and again at the postbulbar region. A total of 250 EGDs were performed. There were 152 males and 98 females, with a mean age of 57.1 (range, 23-91) years. Indications for the procedure were as follows: gastroesophageal reflux disease symptoms 82, epigastric pain 64, dysphagia 46, Barrett's surveillance 25, anemia 23, other research study 16, and other 61. The mean time for the procedure was 11 rain and 54 s, whereas the mean time for the postbulbar examination was 46.6 s. Patients tolerated endoscope insertion well both before and during examination of the postbulbar duodenum. The only postbulbar finding that affected clinical management was a postbulbar ulcer in a patient without other ulcers who was positive for Helicobacter pylori. Although routine endoscopic examination beyond the duodenal bulb involves minimal time and is well tolerated by patients, the yield of pathologic findings is low (3.6%) and the yield of findings that alter clinical management even lower (0.4%). In patients without prior GI surgery undergoing routine EGD for indications other than suspected small bowel pathology or active upper GI bleeding, examination of the postbulbar duodenum can be considered an elective part of the procedure.

KW - Endoscopy

KW - Patient tolerance

KW - Postbulbar duodenum

UR - http://www.scopus.com/inward/record.url?scp=0030970466&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030970466&partnerID=8YFLogxK

U2 - 10.1097/00004836-199704000-00005

DO - 10.1097/00004836-199704000-00005

M3 - Article

VL - 24

SP - 147

EP - 149

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 3

ER -