INVESTIGATIONS DONE IN GIT.pptx

INVESTIGATIONS DONE IN THE GIT SYSTEM

1. INVESTIGATIONS DONE IN GIT BY JAMES NYIRENDA

2. ENDOSCOPIES Endoscopy refers to direct visualization of the body structures through a lighted fiber-optic instrument (endoscope). The structures that can be examined by endoscopy include; oesophagus , stomach, duodenum and colon.

3. . When examining the esophagus, the procedure is called esophageoscopy , stomach – gastroscopy, esophagus, stomach and duodenum

4. , – esophagogastroduodenoscopy (EGD), rectum – sigmoidoscopy and colon up to ileocaecal is colonoscopy . The structures are visualised for motility, inflammation, strictures, ulcers, tumours , etc.

5. , The tube can either be inserted through the mouth or through the anus ( sigmoidocsopy ). The endoscopies are equipped with different instruments such as cameras to take pictures, small clippers to remove tissue samples and electric probe to destroy abnormal tissues. Endoscopies therefore can be used for diagnosis and treatment.

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7. LIVER BIOPSY This is a diagnostic procedure which is done to obtain liver tissue for examination. It is used to diagnose hepatic (liver) diseases. A sample can be obtained during laparotomy or it can involve insertion of a needle between 6 th and 7 th or 8 th and 9 th intercostal spaces on the rig ht. A CT (computed tomography) scan or ultrasound guide is used if a needle is used to obtain the sample.

8. RADIOLOGICAL STUDIES These involve injection or ingestion of a contrast medium followed by x-rays. The contrast medium will give information about the GI tract as it aids visualisation .

9. Barium Swallow This permits radiological visualisation of the oesophagus . It can be used to detect strictures, obstruction, ulcers, tumours , polyps, hiatus hernias and motility problems

10. , It involves the patient drinking radio-opaque contrast medium (barium) and the GI tract being visualised on x-ray fluoroscopy. The lumen will be visualised by the barium so any mucosa destruction, distortion or deviation from the norm can be assessed

11. Barium Meal It’s a fluoroscopic x-ray study that uses contrast medium to diagnose structural abnormalities of stomach and duodenum. The procedure is useful in detecting ulcerations, cancer and obstructions

12. . The patient will be nil by mouth from midnight the day before the test and an enema given the morning of the test. X-rays are taken. It is possible the patient may be given an enema after to clear the barium. The patient needs to be warned of clay coloured stool, which should return to normal in 72 hours. Watch for constipation and abdominal distension.

13. . Barium Enema This is a medical procedure that is diagnose the lower GI tract abnormalities. Preparation involves the patient receiving clear fluids for 2 days prior to the test and a laxative to clear the bowel. Rarely done because of endoscope.

14. ULTRASOUND SCAN Ultrasound scanning or sonography is a non-invasive investigation that is used to obtain pictures or images from different organs inside the human body using high frequency sound waves.

15. . The patient is not exposed to radiation. In abdominal ultrasound the examiner passes a probe against person’s abdomen. The pictures are displayed on a video screen and recorded on a film. Ultra sound can show size and shape of various organs such as the gallbladder, liver and pancreas and can detect abdominal masses, liver diseases, gallstones, etc. Little or no preparation of the patient is needed except explanation.

16. STOOL EXAMINATIONS Stool specimen can be collected to diagnose: 1) Occult blood : detects GI bleeding. Used for an early diagnosis of rectal cancers of the GIT and peptic ulcers. 2) Ova and parasites : stool specimen to detect intestinal infections caused by parasites and ova.

17. . 3. Stool cultures : identify pathogenic organisms in the GI tract. Sterile technique for collection of stool specimens is used. 4) Stool for lipids : normal dietary lipids are absorbed. Excessive secretion of faecal fats ( stetorrhoea ) may occur in various digestive and absorptive disorders. A high fat diet is eaten for 3 days prior to specimen collection, which occurs over 72 hours. Failure of pancreatic lipase to reach the intestine results in undigested and unabsorbed fat.  

18. LIVER FUNCTION TESTS As the liver performs its various functions it makes chemicals that pass into the bloodstream and bile. Various liver disorders alter the blood level of these chemicals. Some of these chemicals can be measured in a blood sample. The tests that are commonly done on a blood sample are called liver function tests (LFTs). These usually measure the following

19. . As the liver performs its various functions it makes chemicals that pass into the bloodstream and bile. Various liver disorders alter the blood level of these chemicals. Some of these chemicals can be measured in a blood sample. The tests that are commonly done on a blood sample are called liver function tests (LFTs). These usually measure the following

20. , As the liver performs its various functions it makes chemicals that pass into the bloodstream and bile. Various liver disorders alter the blood level of these chemicals. Some of these chemicals can be measured in a blood sample. The tests that are commonly done on a blood sample are called liver function tests (LFTs). These usually measure the following

21. . Alanine transaminase (ALT) - This is an enzyme that helps to process proteins. (An enzyme is a protein that helps to speed up chemical reactions). Various enzymes occur in the cells in the body.) Large amounts of ALT occur in liver cells. The levels of ALT usually raise when the liver is injured or inflamed (hepatitis).

22. . Aspartate aminotransferase (AST) - This is another enzyme usually found inside liver cells. High levels of this enzyme in the blood indicate an injury to the liver. This test is not all that specific because it can also raise when there is injury to skeletal and heart muscles. For this reason, ALT is mostly requested than AST.

23. . Alkaline phosphatase (ALP) - This enzyme occurs mainly in liver cells next to bile ducts, and in bone. The blood level is raised in some types of liver and bone disease. It also raises in biliary obstruction.

24. . Albumin –It’s a main protein which is made by the liver and circulates in the blood. A low level of blood albumin indicates liver disorders. Bilirubin – It is a chemical that colors the bile. A high level of bilirubin in blood makes one to be jaundiced ('yellow'). Bilirubin is a by-product of heamoglobin during normal or abnormal RBC heamolysis .

25. , Liver cells take in bilirubin and attach sugar molecules to it. This is then called 'conjugated' bilirubin which is passed into the bile ducts. A raised level of 'unconjugated' bilirubin occurs when there is excessive breakdown of red blood cells. For example, in haemolytic anaemia . Prothrombin time - a laboratory test used to evaluate normal or abnormal blood clotting. Normal range is 11 to 13.5 seconds

26. , A high prothrombin time can be a sign of liver damage. Fat metabolism : This looks at the total serum cholesterol and cholesterol esters. The normal range is < 200mg/dl. Liver function tests are used for diagnosis of liver conditions and also monitoring the toxic effects of some drug

27. . CHOLECYSTOGRAPHY It’s radiological examination of the gall bladder or cystic duct using a radio- opaque contrast medium. The evening before the test the patient ingests a radio-opaque dye. The dye is absorbed by the gut, taken to the liver and secreted in bile, it therefore reaches the gall bladder . This enables the gall bladder to be visualised on a straight abdominal x-ray taken 24 hours after ingestion of the dye.

28. . It can be used to detect gall stones ( cholelithiasis ). X-ray film will show an opaque gall bladder and the gall stones will be seen as dark spots. Poor visualisation indicates gall bladder disease. Biliary obstruction prevents passage of the dye. A sensitivity test should be done first for the dye.

29. . PORTO-SPLENOGRAPHY This is a radiological procedure which is used to detect conditions that affect the spleen. Cholecystography and splenography are rarely done nowadays; investigations such as ultra sound are used instead.

30. . PARACENTESIS ABDOMINIS/ ABDOMINAL PARACENTESIS It is a procedure in which fluid is withdrawn from the abdominal cavity. It involves making an incision in the skin and passing a hollow trocar, cannular , or catheter through the incision into the cavity to allow out flow of fluid into a collecting device. Paracentesis can be done to obtain a sample for analysis or to remove excess fluids in abdominal distension.

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