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Upper endoscopy is used to evaluate for mechanical causes of obstruction. [2] Endoscopic findings may include a hiatal hernia, esophagitis, strictures, tumors, or masses. [ 2 ] Increased pressure at the LES over time may result in an epiphrenic diverticulum. [ 2 ]
Bougie over guidewire dilators are used at the time of gastroscopy or fluoroscopy. An endoscopy is usually performed first to evaluate the anatomy, and a guidewire is passed into the stomach past the obstruction. This may also be done fluoroscopically. Bougies are again introduced—this time over the guidewire—in sequentially increasing sizes.
Esophagogastroduodenoscopy (EGD) or oesophagogastroduodenoscopy (OGD), also called by various other names, is a diagnostic endoscopic procedure that visualizes the upper part of the gastrointestinal tract down to the duodenum.
The causes are divided into benign or malignant. Benign Peptic ulcer disease; Infections, such as tuberculosis; and infiltrative diseases, such as amyloidosis.; A rare cause of gastric outlet obstruction is blockage with a gallstone, also termed "Bouveret syndrome" or "Bouveret's syndrome".
FLIP is most often performed immediately following upper endoscopy (EGD). [1] EGD helps to rule out a mechanical obstruction as a cause for symptoms, and also provides an estimation on the distance from the incisors to the EGJ. [1] FLIP uses impedance planimetry to measure the cross sectional area of the esophageal lumen. [1]
SEMS are used to treat additional complications of cancer, such as tracheoesophageal fistulas from esophageal cancer, [8] and gastric outlet obstruction from stomach, duodenal, or pancreatic cancer. [9] SEMS and self-expanding plastic stents have also been used for non-malignant conditions that cause narrowing or leaks of the esophagus or colon.