ERCP, EUS, and Capsule Endoscopy Flashcards

What is the most common serious complication after ERCP?

Answer: Post-ERCP pancreatitis

Post-ERCP pancreatitis is the most common significant complication, occurring in about 3–10% of cases. Rectal indomethacin and pancreatic duct stents are used to prevent it in higher-risk patients.

How is a patient usually positioned for ERCP?

Answer: Prone or left semi-prone

The prone or left semi-prone position gives the best fluoroscopic view of the biliary and pancreatic ducts and makes it easier to reach the papilla. Nurses must protect the airway and pressure points in this position.

Which condition is a contraindication to video capsule endoscopy unless a patency capsule passes intact first?

Answer: Known or suspected small-bowel stricture or obstruction

The main risk of capsule endoscopy is the capsule getting stuck (retention). A known or suspected stricture or obstruction is a contraindication unless a dissolvable patency capsule passes intact first. Anemia and obscure bleeding are common reasons to order the test.

After a patient swallows a video capsule, when can they usually start drinking clear liquids again?

Answer: About 2 hours after ingestion

Most protocols allow clear liquids about 2 hours after ingestion and a light meal about 4 hours after. Patients wear the recorder for the full study and avoid MRI until the capsule has passed.

What is the main advantage of endoscopic ultrasound with fine-needle aspiration (EUS-FNA)?

Answer: It obtains tissue from pancreatic masses and lymph nodes next to the GI tract

EUS combines endoscopy with high-frequency ultrasound to image structures in and beyond the GI wall. FNA or fine-needle biopsy (FNB) can then sample pancreatic lesions, submucosal tumors and nearby lymph nodes for diagnosis and staging.

Which three principles reduce staff radiation exposure during fluoroscopic ERCP?

Answer: Time, distance, and shielding

Under ALARA (as low as reasonably achievable), staff reduce exposure by limiting fluoroscopy time, increasing distance from the source and using shielding: lead aprons, thyroid collars and lead barriers. Staff also wear dosimeters.