title: Clinical results of observation of the upper gastrointestinal tract by transgastrostomic endoscopy using an ultrathin endoscope.
abstract: OBJECTIVE
  Esophagogastroduodenoscopy through the oral cavity of patients who have undergone percutaneous endoscopic gastrostomy (PEG) causes some distress and puts these patients at risk of aspiration pneumonia. The aim of this study was to evaluate results for the upper gastrointestinal tract by transgastrostomic endoscopy using an ultrathin endoscope.
  
  
  METHODS
  The study subjects were 43 patients, who underwent exchange of a PEG button or tube, 20-French or more in diameter. After PEG buttons or tubes were extracted from the gastrostomy tract, an ultrathin endoscope was inserted through the gastrostomy tract. The stomach and the duodenal bulb were observed and the esophagus was observed in retrograde passage. A new PEG button or tube was then inserted. The rate of successful insertion into the esophagus and duodenal bulb, the observation of the gastrostomy site in retroversion in the stomach, and the endoscopic findings were analyzed.
  
  
  RESULTS
  Ninety-nine examinations were carried out. The esophagus could be observed in 95 (96.0%), the duodenum in 92 (92.9%) and the gastrostomy site in the stomach in all. Gastric polyps were detected in four patients, gastric erosions in two, reflux esophagitis in two, polypoid lesion at the gastrostomy tract in two, gastric ulcer scar in one, duodenal ulcer scar in one, early gastric cancer in one and recurrent esophageal cancer in one. Neither discomfort nor complications occurred during transgastrostomic endoscopy.
  
  
  CONCLUSIONS
  Observation of the upper gastrointestinal tract by transgastrostomic endoscopy using an ultrathin endoscope during a gastrostomy button or tube replacement may be useful and safe.
authors.affiliation: Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan. imaedahi@yahoo.co.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Imaeda
authors.forename: Naoki
authors.initials: N
authors.lastname: Hosoe
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Nakamizo
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kashiwagi
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Saito
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suganuma
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ida
authors.forename: Juntaro
authors.initials: J
authors.lastname: Matsuzaki
authors.forename: Eisuke
authors.initials: E
authors.lastname: Iwasaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Iwao
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ogata
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004386:Duodenum / Q000473:pathology*; D020776:Endoscopes, Gastrointestinal; D016145:Endoscopy, Digestive System / Q000295:instrumentation*; D004867:Equipment Design; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000473:pathology*; D005774:Gastrostomy; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D011237:Predictive Value of Tests; D013270:Stomach / Q000473:pathology*