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Patient s/p Heller and Nissen for achalasia, for screening colonoscopy with propofol sedation. Reflux controlled and swallows fine.
Concerned at all?
Concerned at all?
swallows fine.
Yes, tube, next.
Yup, at the very least prove to me prior post surgical scopes were flawless. But then why the need for the scope....
YesEven with a day of clear liquid diet?
Ok, so I posted and then just ignored everyone’s advice, did the propofol Mac. The guy was just so adamant that his symptoms were gone, including reflux and dysphasia. Better to be lucky than good, (but not really).
How did his esophagus look? Was there a huge column of food?
How did his esophagus look? Was there a huge column of food?
Edit...oops nvm....forgot it was colonoscopy.
This was just a colonoscopy, so I remain blissfully unaware of that column of food.
I wonder if a chest x Ray would be a good tool to rule out anything sitting in the esophagus.
I believe most of these patients get regular follow-ups with a barium swallow. That should give you pretty good information if a recent one is available. I remember the last barium swallow that I reviewed prior to anesthetizing a patient for a Heller Myotomy it looked like a giant bucket of contrast was sitting in his chest all the way up to his oropharynx. That’s when I knew not to take induction on those patients lightly.
Yeah, please tell that to his family after he dies from aspirating.Ok, so I posted and then just ignored everyone’s advice, did the propofol Mac. The guy was just so adamant that his symptoms were gone, including reflux and dysphasia. Better to be lucky than good, (but not really).
how about you put the patient on their head and see if they regurgitate? The UES contributes minimally to prevent regurgitation.