Endoscopic Examination of the Esophagus

Abstract

Endoscopy is well established in the evaluation of esophageal disease. With the widespread availability of endoscopy in nearly every hospital around the world, it has largely supplanted radiological examination as the primary investigation of choice. The major advantage over radiological examination is that the endoscopist can directly visualize the mucosa and obtain targeted biopsy specimens. Furthermore, endoscopic treatment (e.g., balloon dilatation for achalasia or stent inception for esophageal carcinoma) can often be performed immediately after the diagnostic examination. Conventional endoscopy has most recently been complemented by endoscopic ultrasonography, which adds a new dimension to endoscopic diagnostic capability. Using an endoscope equipped with a miniaturized ultrasound transducer at its tip (echoendoscope), or catheter ultrasound probes (‘miniprobes’) that can be inserted through the working channel of a standard endoscope, the endoscopist is able to sonographically “look” into and beyond the esophageal wall.