Consent: Oesophagogastroduodenoscopy - Podcast Version TeachMeSurgery 0:00 / 0:00 1x 0.25x 0.5x 0.75x 1x 1.25x 1.5x 1.75x 2x This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent. Overview of Procedure An oesophagogastroduodenoscopy (OGD) involves an inspection of the oesophagus, stomach, and proximal duodenum with a flexible endoscope. This is often done with the aim of assessing the upper GI tract for a variety of symptoms, such as persistent dyspepsia, haematemesis, unexplained weight loss, and iron-deficiency anaemia. Biopsies can be taken if required, depending on the findings or indication. CC BY-SA 3.0 <http://creativecommons.org/licenses/by-sa/3.0/>, via Wikimedia Commons Figure 1View of stomach (on retroflexion) during a routine OGD Complications Intra-Operative Complication Description of Complication Potential Ways to Reduce Risk Haemorrhage Damage to the oesophagus or stomach (or particularly any varices present) may cause significant bleeding, as well as from any biopsy sites Perforation Although rare, this can occur (particularly if there is an upper GI cancer or pharyngeal pouch) Sedation risk Sedatives, such as midazolam, are often used yet can depress the cardio-respiratory system Always use monitoring and beware of using sedation in frail patients with co-existing cardio-respiratory disease or morbid obesity Damage to teeth Any loose teeth can potentially be dislodged during the procedure by the scope Use a modified mouth guard for patients to allow the scope to pass by the teeth Aspiration Risk of gastric contents entering the lung during the procedure Avoid heavy sedation and ensure prolonged fasting before the procedure Frequent questions What is an oesophagogastroduodenoscopy (OGD)? An oesophagogastroduodenoscopy (OGD) is a diagnostic procedure that allows for the examination of the oesophagus, stomach, and proximal duodenum using a flexible endoscope. It is commonly performed to evaluate symptoms such as persistent dyspepsia, unexplained weight loss, and iron-deficiency anaemia. What are the potential complications of an OGD? Potential complications of an OGD include haemorrhage, perforation, sedation risks, damage to teeth, and aspiration of gastric contents. Awareness of these risks and appropriate precautions can help mitigate them during the procedure. How can the risk of haemorrhage be reduced during an OGD? To reduce the risk of haemorrhage during an OGD, it is crucial to avoid damaging the oesophagus or stomach, particularly in patients with varices. Careful technique and monitoring during biopsy procedures can also help minimise bleeding. Why is sedation used in an OGD, and what are the associated risks? Sedation, often with midazolam, is used in an OGD to enhance patient comfort; however, it can depress the cardio-respiratory system. It is important to monitor patients closely, especially those with pre-existing cardio-respiratory conditions or obesity. What measures can be taken to prevent aspiration during an OGD? To prevent aspiration during an OGD, it is advisable to avoid heavy sedation and ensure that patients fast for an adequate period before the procedure. These steps can help reduce the risk of gastric contents entering the lungs. Rate This Article