Clinical Investigations in Gastroenterology

This book is a completely up-to-date review of the basic tests available in gastroenterology. It is based on a detailed critical analysis of recently described procedures and the review of more traditional methods; each is as signed its correct place in the modern management of patients. Emphasis is placed on those techniques with which the authors have practical experience. The most useful investigations are indicated in the table of contents by heavy type. Comprehensive references are included to provide information about the selection, performance and interpretation of tests. The book is designed for trainees and clinicians without special expertise in gastroenterology, as well as being a shelf manual for the gastroenterologist and the staff of gastrointestinal investigation units. Special thanks are due to the nursing staff of the Day Ward, Bishop Auck land General Hospital; Mr P. Grencis, Medical Photographer; Dr S. Desai, Radiologist; and Amanda Gallagher who typed the manuscript. Malcolm C. Bateson Ian A. D. Bouchier 1988 xu CHAPTER 1 Intubation The passage of various forms of nasogastric, duodenal and intestinal tubes is basic to many of the diagnostic procedures performed in the gastrointestinal system. Method Whenever possible the patient's fullest co-operation should be obtained. If the patient is taking any drugs which might influence the test to be under taken these should be discontinued.

Autorentext

Malcolm Bateson is a medical graduate of Birmingham University. After hospital posts in London and Cambridge he went to Dundee, first as a Research Fellow then as a Lecturer in Medicine. He has been a Consultant Physician and Specialist in Gastroenterology in County Durham since 1981. He is actively associated with research in bile acids and Helicobacter pylori. Ian Bouchier is a medical graduate of Capetown University. In the course of a distinguished medical career he was Reader in Medicine at the Royal Free Hospital and Professor of Medicine at Ninewells Hospital, Dundee. He is currently Professor of Medicine in Edinburgh. He is a world expert in gastroenterology. He is a prolific author and editor, and has produced several standard medical reference textbooks.

Inhalt

1. Intubation.- Method.- Tubes.- Complications.- 2. Upper digestive endoscopy.- Instruments.- Procedure.- Endoscopic retrograde cholangiopancreatography.- Cleansing.- Prophylaxis of S.A.B.E..- 3. Gastrointestinal bleeding.- Occult blood tests.- Gastrointestintal bleeding in liver disease.- 4. Oesophagus.- Oesophageal acid perfusion test.- Oesophagoscopy.- Histology.- Radiology.- Manometry.- Reflux studies.- Isotope swallow.- 5. Stomach and duodenum.- Gastric emptying.- Gastric acid secretion.- Other gastric secretions.- Other tests.- Campylobacter-like organisms.- 6. Absorption.- Fats and related substances.- Monosaccharides.- Rare disorders of absorption.- 7. Small intestine.- Intestinal biopsy.- Interpretation.- Radiology.- Radioisotope studies.- Protein loss.- Intestinal bacteria.- Intestinal motility and manometry.- Markers.- Crohn's disease.- Metabolic disorders.- Immunology.- 8. Colon and rectum.- Rectal examination.- Anoscopy (proctoscopy).- Proctosigmoidoscopy.- Flexible sigmoidoscopy.- Rectal biopsy.- Radiology.- Arteriography.- Colonoscopy.- Manometry.- Immunology.- 9. Stool examination and microbiology.- Macroscopic appearance.- Protozoa and helminths.- Bacteria.- Viruses.- 10. Pancreas.- Ultrasonography.- Endoscopic retrograde cholangiopancreatography.- Computed tomography.- Angiography.- Other radiology.- Peritoneoscopy.- Cytology.- Hormonal tests of pancreatic exocrine function.- Lundh test.- Tubeless oral pancreatic function tests.- Digestive enzymes outside the gut.- Other blood tests.- Stool examination.- Sweat electrolytes.- Gut endocrinology.- Insulinoma.- 11. Liver biochemistry.- Blood and urine tests.- Proteins.- Other tests.- Alcoholic liver disease.- Immunology.- Kinetic tests.- Idiopathic haemochromatosis.- Wilson's disease (hepatolenticulardegeneration).- Hyatid disease.- 12. Liver biopsy.- Preparation.- Procedure.- Aftercare.- Complications.- Indications.- Contradictions.- Interpretation.- Liver aspiration.- 13. Liver imaging and manometry.- Ultrasonic scanning.- Isotope scanning.- Diagnosis of cholestasis.- Portal manometry and splenoportography.- Portography.- 14. Gallbladder and bile ducts.- Plain abdominal radiograph.- Oral cholecystography.- Ultrasonography.- Iodine cholangiography.- Bile duct ultrasound.- Computed tomography.- Isotope scanning.- Operative and post-operative cholangiography.- Biliary physiology.- Bacteriology.- 15. Ascites and the peritoneum.- Abdominal paracentesis.- Chylous ascites.- Peritoneal biopsy.- Peritoneoscopy.- Further reading.