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. It is considered a minimally invasive procedure since it does not require an incision into one of the major body cavities and does not require any significant recovery after the procedure (unless sedation or anesthesia has been used). However, a sore throat is common.

Alternative names

The words esophagogastroduodenoscopy (EGD; American English) and oesophagogastroduodenoscopy (OGD; British English; see spelling differences) are pronounced . It is also called panendoscopy (PES) and upper GI endoscopy. It is also often called just upper endoscopy, upper GI, or even just endoscopy; because EGD is the most commonly performed type of endoscopy, the ambiguous term endoscopy is sometimes informally used to refer to EGD by default. The term gastroscopy literally focuses on the stomach alone, but in practice, the usage overlaps.

Medical uses

thumb|right|450px|Gastroscopy or duodenoscopy is performed for a number of indications, one of the most common being in unexplained anemia, where it is used to diagnose [[gastric ulcer|gastric or duodenal ulcers, among other things.]]

Diagnostic

  • Unexplained anemia (usually along with a colonoscopy)
  • Upper gastrointestinal bleeding as evidenced by hematemesis or melena
  • Persistent dyspepsia in patients over the age of 45 years
  • Heartburn and chronic acid reflux – this can lead to a precancerous lesion called Barrett's esophagus
  • Persistent emesis – vomiting
  • Dysphagia – difficulty in swallowing
  • Odynophagia – painful swallowing
  • Persistent nausea
  • IBD (inflammatory bowel diseases)

Surveillance

  • Surveillance of Barrett's esophagus
  • Surveillance of gastric ulcer or duodenal ulcer
  • Occasionally after gastric surgery

Confirmation of diagnosis/biopsy

  • Abnormal barium swallow or barium meal
  • Confirmation of celiac disease (via biopsy)

Therapeutic

  • Treatment (banding/sclerotherapy) of esophageal varices
  • Injection therapy (e.g., epinephrine in bleeding lesions)
  • Cutting off of larger pieces of tissue with a snare device (e.g., polyps, endoscopic mucosal resection)
  • Application of cautery to tissues
  • Removal of foreign bodies (e.g., food) that have been ingested
  • Tamponade of bleeding esophageal varices with a balloon
  • Application of photodynamic therapy for treatment of esophageal malignancies
  • Endoscopic drainage of pancreatic pseudocyst
  • Tightening the lower esophageal sphincter
  • Dilating or stenting of stenosis or achalasia
  • Percutaneous endoscopic gastrostomy (feeding tube placement)
  • Endoscopic retrograde cholangiopancreatography (ERCP) combines EGD with fluoroscopy
  • Endoscopic ultrasound (EUS) combines EGD with 5–12 MHz ultrasound imaging

Newer interventions

  • Endoscopic trans-gastric laparoscopy
  • Placement of gastric balloons in bariatric surgery

Complications

The complication rate is about 1 in 1000. They include:

  • aspiration, causing aspiration pneumonia
  • bleeding
  • perforation
  • cardiopulmonary problems

When used in infants, the esophagogastroduodenoscope may compress the trachealis muscle, which narrows the trachea. This can result in reduced airflow to the lungs.