Gastrointestinal Endoscopy

The Normal Architecture of the Gastric Folds is observed.

The recognition of abnormalities requires through
knowledge of the normal appearance. This truism is
particularly applicable to diagnostic endoscopy.

 

For more endoscopic details download the video clips by
clicking on the endoscopic images, wait to be downloaded
complete then press Alt and Enter; thus you can observe
the video in full screen.

All endoscopic images shown in this Atlas contain
video clips.

The Endoscopic Sonata no 8 Pathetique

Gastric Folds.

 

 

 

The Endoscopic Dance Macabre

Video Endoscopic Sequence 1 of 8.

High resolution video endoscopy with zoom.
In the video clip you can see the different levels of zoom
1x, 5x and 8x, furthermore this equipment has magnifying
levels of 150x the equivalent of a microscope.

 

 

The Endoscopic Symphony No 40 by MurraSaca

 


 

Video Endoscopic Sequence 2 of 8.

The gastric folds are appreciated.

 

 

 

The Endoscopic Symphony n.º 94 by MurraSaca

 

Video Endoscopic Sequence 3 of 8.

The gastric body is observed in retroflexed maneuver.

 

Video Endoscopic Sequence 4 of 8.

The cardias and fundus regions.

 

Video Endoscopic Sequence 5 of 8.

The antrum and the incisura angularis.

 

Video Endoscopic Sequence 6 of 8.

Gastric Antrum, the peristaltism is observed.

 

Video Endoscopic Sequence 7 of 8.

In this image as well as the video clip the peristaltism is
seen.

 

Video Endoscopic Sequence 8 of 8.

The pylorus and antrum.

 

 

Video Endoscopic Sequence 1 of 6.

The gastric body.

High resolution image.

The rugal folds of the body running longitudinally towards
the antrum.

Video Endoscopic Sequence 2 of 6.

Normal rugal folds of the body.

 

Video Endoscopic Sequence 3 of 6.

The body is seen in retroflexed view, normal rugal folds.

 

Video Endoscopic Sequence 4 of 6.

The fornix and cardia.
The fornix and cardia. The fornix (the vault of the stomach)
and the cardia (surrounding the instrument's shaft) are
better observed by retroverting the instrument's tip.

 

 

Video Endoscopic Sequence 5 of 6.

More images and video clips of the gastric corpus.

Video Endoscopic Sequence 6 of 6.

Symmetrical contraction is observed, The peristalsis of the
antrum.

 

Video Endoscopic Sequence 1 of 8.

In this endoscopic sequence the gastric folds are observed
with close up images using a magnifying endoscope, in the
following images and video clips the chromoendoscopy is
appreciated using methylene blue staining and the gastric
camera has been filled partially with water, which causes a
special and combined acoustic action.

We recommended seeing the complete sequence of video
clips.

 

Video Endoscopic Sequence 2 of 8.

Immersion Endoscopy

Tissue staining during endoscopy (chromoendoscopy) is a
technique used to study the fine details of the mucosa
throughout the gastrointestinal tract.
Chromoendoscopy and vital staining are simple adjunct
methods to improve the yield of endoscopic diagnosis, for
early diagnosis of dysplasias and diagnosis of superficial
and depressed carcinomas. So far the experience shows
improvements over traditional endoscopic diagnosis.
Especially with the help of high resolutions
videoendoscopes, more and more lesions are
recognized in the GI tract, that were not seen with either
fiberendoscopes or first generation videoendoscopes
Contrast staining is used to enhance the mucosal surface
before endoscopic mucosectomy of neoplastic and
malignant lesions. The diagnostic advantage of vital
staining is not yet entirely proven, therefore these methods
are not widely accepted.

 

Video Endoscopic Sequence 3 of 8.

“Submarine in the deep ocean”.

The acoustic action of the water, with the help of a
magnifying endoscope, the gastric mucosa is stained with
methylene blue, offer a new perspective for more accurate
diagnosis mainly in search of tiny injuries and to even
detect carcinomas in early stages.

 

 

Video Endoscopic Sequence 4 of 8.

It has been reported that the fine mucosal patterns of the
gastric pits can be observed with magnification and this
may assist in preliminary evaluation prior to histological
diagnosis.

Video Endoscopic Sequence 5 of 8.

Chromoendoscopy (vital staining and upper endoscopy)
refers to the use of vital stains to identify abnormal
mucosa.

 

Video Endoscopic Sequence 6 of 8.

Immersion Endoscopy.

“The Submarine in the deep ocean”.

 

Video Endoscopic Sequence 7 of 8.

Immersion Endoscopy.

“Submarine in the deep ocean”.

 

Video Endoscopic Sequence 8 of 8.

With this method, previously described, it seems to be
promising mainly in search of tiny injuries and to even
detect carcinomas in early stages.

 

Video Endoscopic Sequence 1 of 5.

The image and the video clip display the gastric body.
There are some sub-epilelial hemorrhage.

 

Video Endoscopic Sequence 2 of 5.

The gastric fundus retroflexed image.
The normal appearance of the gastric fundus on upper GI
endoscopy is shown.

 

Video Endoscopic Sequence 3 of 5.

The image and the video display the peristalsis

Peristalsis is a distinctive pattern of smooth muscle
contractions that propels foodstuffs distally through the
esophagus and intestines.
Peristalsis is a manifestation of two major reflexes within
the enteric nervous system that are stimulated by a bolus of
foodstuff in the lumen. Mechanical distension and perhaps
mucosal irritation stimulate afferent enteric neurons.

 

Video Endoscopic Sequence 4 of 5.

The image and the video display the peristalsis and the
antrum.

 

Video Endoscopic Sequence 5 of 5.

The pylorus.

The normal appearance of the pylorus is observed.

 

Endosonography Sequence 1 of 2.

Endosonography Image of Gastric body.

Radial Endosonography EUS.EUS provides high-frequency imaging in the GI tract providingmore detailed images of the gut wall and surrounding structuresthan any other imaging modality. The method has been mostuseful in evaluating submucosal lesions, staging cancer, anddiagnosing pancreatic and biliary diseases.High-frequency EUS produces uniquely clear and detailedimages of the wall of the gastrointestinal tract andsurrounding organs.No other current imaging method not computed tomography(CT) and not magnetic resonance imaging (MRI) can show thegut wall from the esophagus to the rectum, as a series of layerswith histologic correlates.

 

 

 

 

Endosonography Sequence 2 of 2.

EUS can detect lesions as small as 2-3 mm in size and is the bestmethod for determining the 5 echogenic layers of the stomach. The 5 layers are histologically correlated with the mucosa(layer 1), deep mucosa (layer 2), submucosa (layer 3), muscularispropria (layer 4), and serosa or adventitia (layer 5).

 

The gastric folds.

The gastric fold patterns changes with the degree of air
insufflation.
This endoscopy displays a video clip of the gastric body,
peristaltism of the antrum and the retroflexed maneuver.

 

Video Endoscopy of the Gastric Body.

The greater gastric curvature is seen below, the lesser
gastric curvature is seen upper, the anterior wall to the left
and posterior wall to the right.

 

The video displays an entire video endoscopy.
The fundus is seen, as well as the gastric body and
the antrum with peristalsis.

Normal Stomach.

Rugal folds of the corpus in a mild-distended stomach.

 

Magnifying Endoscopy.

In this image and the video a gastric corpus is observed
with magnifying. Magnified blood vessels are observed.
There are parameters of these structures for the detection
of early gastric carcinoma as well as the helicobacter
pylori using magnifying endoscopes.
It has been reported that the fine mucosal patterns of the
gastric pits can be observed with magnification and thismay
assist in preliminary evaluation prior to histological
diagnosis.

 

Fundus retroflexed image.

The video clip displays some palpitation through the fundus.

 

Endoscopic Insertion.

The video clip shows the insertion of the endoscope
from the oropharynx to the upper esophageal sphincter.
The endoscope should be gently inserted forward at the
right. Endoscope passing posteriorly to the cricoid cartilage
and continued downward towards the cricopharyngeus
muscle with its typically converging folds.

It is very important to relax the patient with
pseudoanalgesic therapy. 

 

Video Endoscopic Sequence 1 of 6.

In this endoscopic sequence, two endoscopes are used,
one emerges through the esophagus and the other is the
one that produces the video, this last is introduced through
gastrostomy fistula.

 

Video Endoscopic Sequence 2 of 6.

The endoscope which emerges from the cardia to the gastric camera.

 

Video Endoscopic Sequence 3 of 6.

Another image and video, in this video clip is observed that
the videoendoscope leaves from the esophagus towards the
stomach, which is filmed with another video endoscope
that is introduced to the gastric camera through a
gastrostomy fistula.

 

Video Endoscopic Sequence 4 of 6.

Gastric Cardias.

 

Video Endoscopic Sequence 5 of 6.

The maneuver of retroversion is observed.

 

Video Endoscopic Sequence 6 of 6.

The endoscope throughout the gastric camera.

 

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