Gastroenterology
The Digestive Endoscopy service at Clínica São Vicente offers the following diagnostic and therapeutic exams and procedures:
- Colonoscopy
- Upper Digestive Endoscopy
- Flexible rectosigmoidoscopy
- Endoscopic retrograde cholangiopancreatography
Digestive Endoscopy
The Upper Digestive Endoscopic exam sometimes causes unjustified concerns. In fact, it is usually simpler and less invasive than most people think. It is indicated to examine the upper digestive tract (oesophagus, stomach and duodenum). The most frequently diagnosed diseases are the inflammations in the oesophagus (oesophagitis), hiatus hernia, ulcers, gastritis, duodenum inflammations (duodenitis) and tumours. The endoscopy makes it possible to remove polyps and small and superficial malignant lesions and to treat problems such as the dilation of the narrow areas, varixes in the oesophagus, as well as to stop bleeding ulcers and for the placement of feeding tubes.
The simple exams, with no therapeutic procedure associated to it, last between five and ten minutes, with sedation only to reduce the patient’s anxiety and lack of comfort. A very thin and flexible tube is inserted into the mouth and through the upper digestive tract. The videoendoscopy system allows the physicians to observe, through a monitor the mucus that is being examined.
Colonoscopy
An exam indicated to investigate diseases in the intestine such as polyps, diverticular disease, diarrhoea, constipation and tumours. It is also used for the prevention of intestine cancer and for the early detection of cancer. Before the exam the intestine is “cleaned” with an appropriate diet and laxative medication.
The device, a thin and flexible tube with a camera which allows the mucus of the large intestine is introduced through the anus. The exam is done with the patient sedated and constantly monitored. During the colonoscopy, some therapeutic procedures can also be performed such as the removal of polyps. The risk of complications is very small, around 0.2% to 0.5%, according to global statistics if performed by an experienced team and with the appropriate equipment.
Rectosigmoidoscopy
In this case the colonoscopy is restricted to a specific area of the intestine, including only the rectum and a portion of the large intestine (sigmoid). It is indicated to investigate cancer and in cases of acute diarrhoea and lower bleeding in emergency cases, when the need for quicker diagnosis prevents the preparation of the colon.
Endoscopic retrograde cholangiopancreatography
It is the exam indicated to investigate tumours, obstructions and bile duct and pancreas calculus. It is performed in the surgical centre with radiological monitoring. A catheter is introduced through the flexible tube of the endoscope up to the duodenal papilla, where a contrast agent is injected to allow the bile channels to be seen. Removing calculus, drainage and placing prosthesis are some of the therapeutic indications of the cholangiopancreatography.
As it is a complex method, that involves extremely delicate structures, it is necessary to have the patient hospitalized in observation for at least 12 hours after the exam. The risk of complications, around 2%, is considered low compared to the surgical option and taking into account the severity of the patients.
NOTE: Before any exam, the patient or guardian, is informed and receives guidance on all the possibilities, and as a routine signs consent to conduct the exam.