Introduction to Gastroenterology, diagnostic and invasive endoscopy

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Introduction to Gastroenterology, diagnostic and
invasive endoscopy

• Professor Yaron Niv
• Rabin Medical Center
• Tel Aviv University

2
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  (???? 48).
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  ?????? ???????.
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  ??????, ????? 50 ??', ???????? 1 ??'.
• ??????????? ??? ???????. ??????? ??????? ?????,
  ????? HE ?????? ??????.
• ???? ??? ? EUS - ??????????.
• ???????????? ??? ????? ??????? ?? CRC.

3
??????, ??????? ??????

• ??? ???? ?? ???? ????
• ??? ??? ??????? ?? NSAIDs?
• ??? ?? ???????
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• ????? ?????, ?????, ???????? (??????)
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• ?????? (?????)
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  ???????????, ?????? ?????? ????????
• ?????? ???????????, ?????, ????? ?????, ??????
  ????? ????? ???????? ???????????
• ???? ???? ??????
• ????, rectal shelf

• ??????? inspection
• ????? auscultation
• ????? palpation
• ????? percussion
• ????? ???????

5
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• ??? ????, ?????, ???????, ?????? ?? ???????????
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• ????? ??
• ????? ?? ? CRP
• ???????
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6
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• ???? ??? ????? ????? ???? ????, ????????, ?????
• ????? ??????? ???? ???-????-???????-??? ??
  (???????????), ???? ?????
• US, CT, CT angio, virtual colonoscopy, MRI, MRCP,
  ??????????, ?????????????

7
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????? ??? ????
??????
????? ??????
8
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9
CT
????? ????
????? ???? ??????
10
MRI
????? ????? ??-???
?????? ???????? ????
11
?????? ????????????????

• ??????-?????-?????????????
• ???????????? (???????????????, ??????????,
  ?????????)
• ???????????, ?????? ??????????
• ERCP
• EUS
• ????????
• ????? pH
• ?????? ?????

12
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13
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14
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• ????? ????? ????? ???????
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• ?????/???? ??????
• ????? ?? ???? ????? ???????
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• ????? ?????????
• ????? ?? ????? (??????? ???? ??)

15
????? ????? ?? ????? ???? ???????

• ????????? ?? ??? ???? (??? ?"? ???)
• ??????? ????? ????????
• ??? ???? ????? ?? ????????
• ???? ???, ????, ????
• ?????? ?? ?????
• ?????????

16
????? ????? ?? ???? ????? ?????? ????????

• ?????????, ????????, ??????????
• ????? ???? ?? ?????
• ??? ???? ?"? ????? ????
• ??? ????? ?? ????????
• Dieulafoys lesion
• Vascular ectasia

17
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• ?????????? / ????? ?????
• ??????
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• ????? ??????/?????/????? ?????

18
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20
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21
??????-????? ????????? - ??????

• ????? ???? ????? ?? ????? ????? ????????.
• ???? ????? ????? ??? ?????, ????? ??????? ???
  ?????? ???.
• ???? ?????? ????? .
• ???? ?????? ?????? ???????? ???? ??????.
• ?????/???????/????????? ??????? ????? ???????
  ??????.

22
?????? ?EUS
23
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24
?????? ?????????????

• ????? ????? ?? ???? ???? ???.
• ????? ???? ????/??? ????? ???? ?????? ????? ????
  ?? ???? ?????? ??? ????.
• ??????? ?????? ?????.
• ??? ??????/??? ????? ????? ?? ? CT.
• ????? ????? ?? ??? ?????/????????????.
• ???? ??? ??????? ?????? ?? ???????? ?????.
• ????? ????? ??? ????? ??? ???????.
• ?????????? ?????? ?????? ???.

25
??????????, ?????????

• ?????? ??????????? ??????? ???? ??????? ?? ????
  ??? ?????????? ?????? 25 ?? ?????? ?? ????
  (?????), ????????? ?????? 3 ?? ?????? (????)
• ?????? ??? ????, ???? ???
• ???? ????? ???????, ?????? ?? ???????, ?????
  ??????

26
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27
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28
?????? ?????????????
???
?????????
???? ????
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????? pH

• ????? ??? ???????? ???? ????? ???? ??? ????? ????
  ???? ???? ?? ???????
• ????????
• ????? ?????????? ????, ????? ????? ?????
  ?????????? ????? ??????? ???????????, ?????
  ?????? ??????????

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PillCam SB Capsule Components
Dimensions Height 11mm Width 26mm Weight
3.7gr

• 1. Optical dome
• 2. Lens holder
• 3. Lens
• 4. Light emitting diodes
• 5. Semiconductor
• 6. Battery
• 7. Transmitter
• 8. Antenna

• Pilcam, Given Imaging, Yoqneam, Israel
• Ingestible capsule, data recorder, work station
• 2 pictures every second, 57,600 for 8 hours

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Normal Villi in the Small Bowel

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PillCam Capsule Endoscopydetecting Crohns
disease


in the wall of the small intestine
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A.Z. Small Bowel Low Grade Lymphoma in duodenal
and ileal biopsies

• ???? ?? 32 ?????? ?? ???????, ???? ??? ????
• ????????????, ?????????? ???????????? ?? ????????
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