DIAGNOSTIC AND THERAPEUTIC ENDOSCOPY THROUGH THE GASTRONOMY SITE

We report a successful diagnostic and therapeutic endoscopy through th e gastrostomy site in two patients in whom conventional antegrade uppe r endoscopy was not possible. In one, the endoscopic and histologic di agnosis of a completely obstructing malignant lesion in the upper esop hagus was possible by retrograde intubation using a bronchoscope. In t he other, the gastrostomy site was used to gain access and assist in t he placement of a jejunostomy tube. We describe a technique to help ci rcumvent the lack of air insufflation with the bronchoscope. Both endo scopies were carried out without the need for drugs for conscious seda tion. This percutaneous route, through a gastrostomy site, in the tech nique described by us uses a readily available endoscope in any hospit al setting, does not need conscious sedation, and does not need dilati on of the stoma site, allowing access to the gastrointestinal tract fo r diagnostic and therapeutic purposes.