View More View Less
  • 1 Fővárosi Önkormányzat Uzsoki Utcai Kórháza II. Belgyógyászat Budapest Uzsoki u. 29–41. 1145
Restricted access

A terhességben végzett emésztőrendszeri endoszkópos vizsgálóeljárásokkal kapcsolatos irodalmi adat kevés. Az endoszkópiáknak mindössze 0,4%-át végzik terheseken. Kazuisztikák és néhány, kis esetszámot feldolgozó retrospektív adat áll rendelkezésre. A graviditás során bekövetkező élettani változások miatt az endoszkópia elvileg több veszéllyel járhat. Az indikáció felállítását nehezíti, hogy a tünetek, panaszok egy része lehet a terhesség következménye is, de állhat a háttérben akár gasztroenterológiai megbetegedés is. A biztonságos vizsgálat feltételeiről is keveset tudunk. Nemcsak az endoszkópia okozta kockázattal, hanem a beavatkozás során alkalmazott gyógyszerek, kontrasztanyag, röntgensugár és az endoszkópos terápia potenciális veszélyeivel is számolni kell. Endoszkópiára csak akkor kerüljön sor, ha az indikáció megkérdőjelezhetetlen és terápiás konzekvenciákkal is bír. A gravida csak FDA szerinti „A” és „B” kategóriájú készítményeket kaphat. A vérzés és az alarm tünetekkel járó pyrosis egyértelmű indikációi a gasztroszkópiának. A hányinger, a hányás, az epigastrialis fájdalmak és a székletvérteszt pozitív eredménye endoszkópiát nem, legfeljebb gasztroenterológiai konzíliumot indokolnak. Vérzés, rectum-szigma térfoglaló folyamat, illetve stenosis és súlyos atípusos hasmenés esetén szigmoidoszkópiát kell végezni. Létjogosultsága csak a terápiás endoszkópos retrográd cholangiopancreatographiának van. Az obstrukciós icterus és a biliaris pancreatitis azonnali endoszkópos terápiát igényelnek. A röntgensugárzás ellen a magzat védhető, és így az őt érő dózis a teratogén tartomány alatt marad. Orv. Hetil., 2011, 152, 1043–1051.

  • Cappell, M. S.: The fetal safety and clinical efficacy of gastrointestinal endoscopy during pregnancy. Gastroenterol. Clin. North Am., 2003, 32, 123–179.

    Cappell M. S. , 'The fetal safety and clinical efficacy of gastrointestinal endoscopy during pregnancy ' (2003 ) 32 Gastroenterol. Clin. North Am. : 123 -179.

    • Search Google Scholar
  • Zágoni T., Juhász E. D., Sipos F. és mtsa: Endoszkópos vizsgálatok terhességben. Orv. Hetil., 2007, 148, 1181–1184.

    Sipos F. , 'Endoszkópos vizsgálatok terhességben ' (2007 ) 148 Orv. Hetil. : 1181 -1184.

  • Cheek, T. G., Baird, E.: Anesthesia for nonobstetric surgery: maternal and fetal considerations. Clin. Obstet. Gynecol., 2009, 52, 535–545.

    Baird E. , 'Anesthesia for nonobstetric surgery: maternal and fetal considerations ' (2009 ) 52 Clin. Obstet. Gynecol. : 535 -545.

    • Search Google Scholar
  • Pilkington, S., Carli, F., Dakin, M. J. és mtsai: Increase in Mallampati score during pregnancy. Br. J. Anaesth., 1995, 74, 638–642.

    Dakin M. J. , 'Increase in Mallampati score during pregnancy ' (1995 ) 74 Br. J. Anaesth. : 638 -642.

    • Search Google Scholar
  • Novák J., Takács T., Újszászy L. és mtsai: A gasztroenterológiai megbetegedések ellátása a várandósság alatt. LAM, 2007, 17, 289–296.

    Újszászy L. , 'A gasztroenterológiai megbetegedések ellátása a várandósság alatt ' (2007 ) 17 LAM : 289 -296.

    • Search Google Scholar
  • Cohen-Kerem, R., Railton, C., Oren, D. és mtsai: Pregnancy outcome following non-obstetric surgical intervention. Am. J. Surg., 2005, 190, 467–473.

    Oren D. , 'Pregnancy outcome following non-obstetric surgical intervention ' (2005 ) 190 Am. J. Surg. : 467 -473.

    • Search Google Scholar
  • Vinod, J., Bonheur, J., Korelitz, B. I. és mtsa: Choice of laxatives and colonoscopic preparation in pregnant patients from the viewpoint of obstetritians and gastroenterologists. World J. Gastroenterol., 2007, 13, 6549–6552.

    Korelitz B. I. , 'Choice of laxatives and colonoscopic preparation in pregnant patients from the viewpoint of obstetritians and gastroenterologists ' (2007 ) 13 World J. Gastroenterol. : 6549 -6552.

    • Search Google Scholar
  • Nguyen, G. C., Dinani, A. M., Pivovarov, K.: Endoscopic management and outcomes of pregnant women hospitalized for nonvariceal upper GI bleeding: a nationwide analysis. Gastrointest. Endosc., 2010, 72, 954–959.

    Pivovarov K. , 'Endoscopic management and outcomes of pregnant women hospitalized for nonvariceal upper GI bleeding: a nationwide analysis ' (2010 ) 72 Gastrointest. Endosc. : 954 -959.

    • Search Google Scholar
  • Cappell, M. S., Colon, V. J., Sidhom, O. A.: A study of eight medical centers of the safety and clinical efficacy of esophagogastroduodenoscopy in 83 pregnant females with follow-up of fetal outcome with comparison control groups. Am. J. Gastroenterol., 1996, 91, 348–354.

    Sidhom O. A. , 'A study of eight medical centers of the safety and clinical efficacy of esophagogastroduodenoscopy in 83 pregnant females with follow-up of fetal outcome with comparison control groups ' (1996 ) 91 Am. J. Gastroenterol. : 348 -354.

    • Search Google Scholar
  • O’Mahony, S.: Endoscopy in pregnancy. Best Pract. Res. Clin. Gastroenterol., 2007, 21, 893–899.

    O’Mahony S. , 'Endoscopy in pregnancy ' (2007 ) 21 Best Pract. Res. Clin. Gastroenterol. : 893 -899.

    • Search Google Scholar
  • ASGE guideline: guidelines for endoscopy in pregnant and lactating women. Gastrointest. Endosc., 2005, 61, 357–362.

  • Irving, P. M., Howell, R. J., Shidrawi, R. G. és mtsa: Percutaneous endoscopic gastrostomy with a jejunal port for severe hyperemesis gravidarum. Eur. J. Gastroenterol. Hepatol., 2004, 16, 937–939.

    Shidrawi R. G. , 'Percutaneous endoscopic gastrostomy with a jejunal port for severe hyperemesis gravidarum ' (2004 ) 16 Eur. J. Gastroenterol. Hepatol. : 937 -939.

    • Search Google Scholar
  • Shaheen., N. J., Crosby, M. A., Grimm, I. S. és mtsa: The use of percutaneous endoscopic gastrostomy in pregnancy. Gastrointest. Endosc., 1997, 46, 564–565.

    Grimm I. S. , 'The use of percutaneous endoscopic gastrostomy in pregnancy ' (1997 ) 46 Gastrointest. Endosc. : 564 -565.

    • Search Google Scholar
  • Gyökeres, T., Topa, L., Marton, I. és mtsa: Endoscopic cystogastrostomy during pregnancy. Gastrointest. Endosc., 2001, 53, 516–518.

    Marton I. , 'Endoscopic cystogastrostomy during pregnancy ' (2001 ) 53 Gastrointest. Endosc. : 516 -518.

    • Search Google Scholar
  • ACOG Committee on Obstetric Practice: ACOG Committee Opinion No. 474: Nonobstetric surgery during pregnancy. Obstet. Gynecol., 2011, 117, 420–421.

    'ACOG Committee Opinion No. 474: Nonobstetric surgery during pregnancy ' (2011 ) 117 Obstet. Gynecol. : 420 -421.

    • Search Google Scholar
  • Cappell, M. S., Fox, S. R., Gorrepati, N.: Safety and efficacy of colonoscopy during pregnancy: an analysis of pregnancy outcome in 20 patients. J. Reprod. Med., 2010, 55, 115–123.

    Gorrepati N. , 'Safety and efficacy of colonoscopy during pregnancy: an analysis of pregnancy outcome in 20 patients ' (2010 ) 55 J. Reprod. Med. : 115 -123.

    • Search Google Scholar
  • Yaghoobi, M., Koren, G., Nulman, I.: Challenges to diagnosing colorectal cancer during pregnancy. Can. Fam. Physician, 2009, 55, 881–885.

    Nulman I. , 'Challenges to diagnosing colorectal cancer during pregnancy ' (2009 ) 55 Can. Fam. Physician : 881 -885.

    • Search Google Scholar
  • Cappell, M. S., Colon., V. J., Sidhom, O. A.: A study at 10 medical centers of the safety and efficacy of 48 flexible sigmoidoscopies and 8 colonoscopies during pregnancy with follow-up of fetal outcome and with comparison to control groups. Dig. Dis. Sci., 1996, 41, 2353–2361.

    Sidhom O. A. , 'A study at 10 medical centers of the safety and efficacy of 48 flexible sigmoidoscopies and 8 colonoscopies during pregnancy with follow-up of fetal outcome and with comparison to control groups ' (1996 ) 41 Dig. Dis. Sci. : 2353 -2361.

    • Search Google Scholar
  • Soehendra, N.: Surgery in pregnancy from an endoscopy viewpoint. Langenbecks Arch. Chir., 1981, 355, 229–231.

    Soehendra N. , 'Surgery in pregnancy from an endoscopy viewpoint ' (1981 ) 355 Langenbecks Arch. Chir. : 229 -231.

    • Search Google Scholar
  • Baillie, J., Cairns, S. R., Putman, W. S. és mtsa: Endoscopic management of choledocholithiasis during pregnancy. Surg. Gynecol. Obstet., 1990, 171, 1–4.

    Putman W. S. , 'Endoscopic management of choledocholithiasis during pregnancy ' (1990 ) 171 Surg. Gynecol. Obstet. : 1 -4.

    • Search Google Scholar
  • Zágoni, T., Tulassay, Z.: Endoscopic sphincterotomy without fluoroscopic control in pregnancy. Am. J. Gastroenterol., 1995, 90, 1028.

    Tulassay Z. , 'Endoscopic sphincterotomy without fluoroscopic control in pregnancy ' (1995 ) 90 Am. J. Gastroenterol. : 1028 -.

    • Search Google Scholar
  • Al-Hashem, H., Muralidharan, V., Cohen, H. és mtsa: Biliary disease in pregnancy with an emphasis on he role of ERCP. J. Clin. Gastroenterol., 2009, 43, 58–62.

    Cohen H. , 'Biliary disease in pregnancy with an emphasis on he role of ERCP ' (2009 ) 43 J. Clin. Gastroenterol. : 58 -62.

    • Search Google Scholar
  • Chong, V. H., Jalihal, A.: Endoscopic management of biliary disorders during pregnancy. Hepatobiliary Pancreat. Dis. Int., 2010, 9, 180–185.

    Jalihal A. , 'Endoscopic management of biliary disorders during pregnancy ' (2010 ) 9 Hepatobiliary Pancreat. Dis. Int. : 180 -185.

    • Search Google Scholar
  • ACOG Committee on Obstetric Practice: ACOG Committee Opinion. Number 299, September 2004. Guidelines for diagnostic imaging during pregnancy. Obstet. Gynecol., 2004, 104, 647–651.

    'ACOG Committee Opinion. Number 299, September 2004. Guidelines for diagnostic imaging during pregnancy ' (2004 ) 104 Obstet. Gynecol. : 647 -651.

    • Search Google Scholar
  • Daas, A. Y., Agha, A., Pinkas, H. és mtsa: ERCP in pregnancy. Is it safe? Gastroenterol. Hepatol., 2009, 5, 851–855.

    Pinkas H. , 'ERCP in pregnancy. Is it safe? ' (2009 ) 5 Gastroenterol. Hepatol. : 851 -855.

  • Shelton, J., Linder, J. D., Rivera-Alsina, M. E. és mtsa: Commitment, confirmation, and clearance: new techniques for nonradiation ERCP during pregnancy (with videos). Gastrointest. Endosc., 2008, 67, 364–368.

    Rivera-Alsina M. E. , 'Commitment, confirmation, and clearance: new techniques for nonradiation ERCP during pregnancy (with videos) ' (2008 ) 67 Gastrointest. Endosc. : 364 -368.

    • Search Google Scholar
  • Sharma, S. S., Maharshi, S.: Two stage endoscopic approach for management of choledocholithiasis during pregnancy. J. Gastrointestin. Liver Dis., 2008, 17, 183–185.

    Maharshi S. , 'Two stage endoscopic approach for management of choledocholithiasis during pregnancy ' (2008 ) 17 J. Gastrointestin. Liver Dis. : 183 -185.

    • Search Google Scholar
  • Fishman, D. S., Tarnasky, P. R., Patel, S. N. és mtsa: Management of pancratobiliary disease using a new intra-ductal endoscop: the Texas experience. World J. Gastroenterol., 2009, 15, 1353–1358.

    Patel S. N. , 'Management of pancratobiliary disease using a new intra-ductal endoscop: the Texas experience ' (2009 ) 15 World J. Gastroenterol. : 1353 -1358.

    • Search Google Scholar
  • Girotra, M., Jani, N.: Role of endoscopic ultrasound/SpyScope in diagnosis and treatment of choledocholithiasis in pregnancy. World J. Gastroenterol., 2010, 16, 3601–3602.

    Jani N. , 'Role of endoscopic ultrasound/SpyScope in diagnosis and treatment of choledocholithiasis in pregnancy ' (2010 ) 16 World J. Gastroenterol. : 3601 -3602.

    • Search Google Scholar
  • Jamidar, P. A., Beck, G. J., Hoffmann, B. J. és mtsai: Endoscopic retrograde cholangiopancreatography in pregnancy. Am. J. Gastroenterol., 1995, 90, 1263–1267.

    Hoffmann B. J. , 'Endoscopic retrograde cholangiopancreatography in pregnancy ' (1995 ) 90 Am. J. Gastroenterol. : 1263 -1267.

    • Search Google Scholar
  • Tang, S. J., Mayo, M. J., Rodriguez-Frias, E. és mtsai: Safety and utility of ERCP during pregnancy. Gastrointest. Endosc., 2009, 69, 453–461.

    Rodriguez-Frias E. , 'Safety and utility of ERCP during pregnancy ' (2009 ) 69 Gastrointest. Endosc. : 453 -461.

    • Search Google Scholar
  • Pitchumoni, C. S., Yegneswaran, B.: Acut pancreatitis in pregnancy. World J. Gastroenterol., 2009, 15, 5641–5646.

    Yegneswaran B. , 'Acut pancreatitis in pregnancy ' (2009 ) 15 World J. Gastroenterol. : 5641 -5646.

    • Search Google Scholar
  • Tang, S., Rodriguez-Frias, E., Singh, S. és mtsai: Acute pancreatitis during pregnancy. Clin. Gastroenterol. Hepatol., 2010, 8, 85–90.

    Singh S. , 'Acute pancreatitis during pregnancy ' (2010 ) 8 Clin. Gastroenterol. Hepatol. : 85 -90.

    • Search Google Scholar
  • Hernandez, A., Petrov, M. S., Brooks, D. C. és mtsai: Acute pancreatitis and pregnancy: a 10-year single center experience. J. Gastrointest. Surg., 2007, 11, 1623–1627.

    Brooks D. C. , 'Acute pancreatitis and pregnancy: a 10-year single center experience ' (2007 ) 11 J. Gastrointest. Surg. : 1623 -1627.

    • Search Google Scholar
  • Waterman, M., Eliakim, R.: Capsule enteroscopy of the small intestine. Abdom. Imaging, 2009, 34, 452–458.

    Eliakim R. , 'Capsule enteroscopy of the small intestine ' (2009 ) 34 Abdom. Imaging : 452 -458.

    • Search Google Scholar
  • Storch, I., Barkin, J. S.: Contraindications to capsule endoscopy: do any still exist? Gastrointest.; Endosc. Clin. N. Am., 2006, 16, 329–336.

    Barkin J. S. , 'Contraindications to capsule endoscopy: do any still exist? ' (2006 ) 16 Gastrointest.; Endosc. Clin. N. Am. : 329 -336.

    • Search Google Scholar
All Time Past Year Past 30 Days
Abstract Views 67 67 12
Full Text Views 8 6 0
PDF Downloads 4 4 0