OGD---The lumen of the upper digestive tract-

Oesophagogastroduodenoscopy (OGD)

OGD is the method for examination of the lumen of the upper digestive tract. OGD means the use of a flexible endoscope to examine the oesophagus (Oesopha-), stomach (Gastro-) and duodenum (Duodeno-). 

OGD is indicated for diagnosis, biopsy and delivery of targeted therapies. It may be used for patients suffering from peptic ulcer disease or bleeding, suspected oesophageal and gastric cancer, symptoms of indigestion, acid reflux and difficulty in swallowing.



Procedures
1. Prior to the examination, local anesthetics will be sprayed to the throat of patients. During the procedure, patients are fully conscious.
2. A flexible endoscope with a diameter of 0.9-1.2cm will then be introduced by the endoscopist through patients’ mouth into the esophagus, stomach and the duodenum.
3. Blood pressure and heart rate will be closely monitored during the procedure.
4. The entire procedure will last for about 10 to 20 minutes.





Reference: psclinic.com.hk/
The information aims to provide educational purpose only. Anyone reading it should consult
Surgery Specialist before considering treatment and should not rely on the information
above.

Hernia

Hernia is the protrusion of the whole or part of a viscous from its normal position through an opening in the walls of its containing cavity.

Causes of hernia

Hernia can be either congenital or acquired. Increased intra-abdominal pressure or collagen derangement may also increase the risk of developing hernia.

Types of hernia

Hernia can be classified either by their clinical features or their sites. Clinical features include reducible, irreducible, strangulated and incarcerated / obstructed hernia. Sites include inguinal, femoral, umbilical and paraumbilical, incisional, epigastric, obturator, etc.

Symptoms

If you have any of the following symptoms, you may be experiencing hernia:

˙    A lump over the abdominal wall (eg. Groin)

˙    The lump may increase in size progressively

˙    Occasional pain

˙    Disappear when lying flat

˙    Lump size increases if patient is in standing position or coughing

Complications of hernia

When the hernia becomes strangulated, the blood supply to the content of hernia is impaired. The content becomes ischemia and then gangrenous, resulting in peritonitis.

Emergent operation is then required for this life threatening condition. You may experience severe pain over the lump, which could not be reduced. The overlying skin becomes redden and the pain will become severer and then spread out to the entire abdomen

Hernia treatment

Surgical repair is the only effective treatment for hernia. Conservative treatment is the exception rather the rule. Open hernia repair with mesh and laparoscopic hernia repair are two commonly used surgical treatment.

Open and laparoscopic surgeries are both common for hernia repair, decisions are made according to patients’ condition. Open surgery is more preferred for patients with recurrent hernia.

Reference: psclinic.com.hk/

The information aims to provide educational purpose only. Anyone reading it should consult

Surgery Specialist before considering treatment and should not rely on the information

above.

Gallstones

A gallstone is a crystalline concretion formed within the gallbladder by accretion of bile components

Classification

There are three major types of gallstones, namely cholesterol, pigmented and mixed stones.

Risk factors for gallstones:

•        Fat
•        Female
•        Fifty
•        Fertile
•        Others:
•        Hemolytic disease
•        Biliary tract infection
• 
  

Symptoms

Some patients may be asymptomatic. About 10% may become symptomatic within 5 years. Those symptoms include vague upper abdominal pain, dyspepsia and flatulence. If patients experience intense pain over right upper quadrant of abdomen, that may be the symptom of biliary colic.

Diagnosis

Diagnosis is made by clinical assessment and ultrasound examination.

Gallbladder cancer

Gallbladder cancer is a relatively uncommon cancer, most commonly seen in elderly ladies. For cases that are diagnosed early, patients can be cured by removing the gallbladder, part of the liver and associated lymph nodes. Endoscopic retrograde cholangiopancreatography (ERCP) is a common endoscopic surgery performed for such cases.

Complications of gallstones

Listed below are common complications of gallstones

•        Acute cholecystitis: this may cause empyema,
  gangrenous, perforation, peritonitis
•        Chronic cholecystitis – recurrent biliary colic
•        Cholecystointestinal fistula
•        Carcinoma – porcelain gallbladder

If gallstones migrate into the ducts of the biliary tract, the condition is referred to as choledocholithiasis, which is frequently associated with obstruction of the biliary tree. This may lead to acute ascending cholangitis, a serious infection of the bile ducts.

Gallstones within the ampulla of Vater may obstruct the exocrine system of the pancreas, which in turn can result in pancreatitis.

Either of these two conditions can be life-threatening and are therefore considered to be medical emergencies.

Gallstones Treatment

•         Surgery. Laparoscopic cholecystectomy is the standard
   treatment of gallstone disease.
•         Medical dissolution therapy
•          Extracorporeal shock wave lithrotripsy

Gallbladder polyps

Gallbladder polyps are growths or lesions resembling growths (polypoid lesions) in the wall of the gallbladder. Most polyps are benign and do not need to be removed.

However, for patients over 50 years old with polyps larger than 1 cm, they may have the gallbladder removed (cholecystectomy), especially if there are several polyps or the polyps appear to be malignant. 

Reference: psclinic.com.hk/

The information aims to provide educational purpose only. Anyone reading it should consult

Surgery Specialist before considering treatment and should not rely on the information

above.