Oesophagoscopy

Indications of oesophagoscopy:

1. Removal of foreign bodies

2. Examination and biopsy of lesions from oesophagus

3. Dilatation of oesophagal strictures (benign)

4. Treatment of pharyngeal pouch

Anesthesia used:

Local (topical) 4% xylocaine spray, and pyriform fossa block. General anesthesia is reserved for removal of impacted foreign bodies

Premedication:

1. Injection Glycopyrrolate 0.2 mg intra muscular injection is given as premedication to prevent excessive secretions in the throat.

2. Injection fortwin 1 ampule intramuscular is given

Instruments used:

1. Rigid oesophagoscope - Two types are available. Negus type and Jackson's type. They differ from each other in the type of illumination.

Negus type: In this oesophagoscope the illumination is at the Proximal end of the scope. The biggest disadvantage is that the illuminating tip is present at the proximal end and is not very bright. Jackson's type: This type of oesophagoscope has distal illumination. The illumination is brighter than that of Negus type since it is present at the distal end. The major disadvantage is that it could get soiled with blood and secretions.

2. Flexible oesophagoscope

Position of patient on the table: Boyce position. In this position the patient lies supine with ring below the head. The neck is flexed and the head is extended at the atlanto-occipital joint.

Complications:

1. Oesophageal perforation

2. Injury to teeth, lips, gums, and cervical spine

3. Rupture of aortic aneurysm