Endoscopy: 6 - Brossura

Barnes, Roger W. W.; Bergman, R.T.; Hadley, H.L.

Brossura

ISBN 10: 3642865739 ISBN 13: 9783642865732

Casa editrice: Springer, 2012

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Contenuti

I — Diagnostic Endoscopy.- I — Endoscopic armamentarium.- A. Endoscopes.- I. Direct vision endoscopes.- 1. Advantages.- 2. Cystoscopes.- 3. Urethroscopes.- a) Internal illumination.- b) External illumination.- IL Lens endoscopes.- 1. Advantages.- 2. Optical systems used in endoscopes.- a) Right angle.- b) Obliquely forward.- c) Retrograde.- d) Directly forward.- e) Adjustable.- 3. Telescopes.- a) Wiring circuit.- b) Catheter guides and deflectors.- c) Protection of catheters.- d) Carriage for telescopes.- III. Endoscope sheaths.- 1. Illumination. Types of sheaths.- 2. Beaks and fenestrae of sheaths.- 3. Light posts.- 4. Stopcocks.- 5. Obturators.- 6. Locks.- IV. Sizes of endoscopes.- V. Instruments designed for endoscopic surgery.- 1. Stern McCarthy visual prostatic electrotome.- 2. Resectoscope made by Wolf (Germany).- 3. Modifications of the McCarthy electrotome.- 4. Visual lithotrites.- Telescope.- B. Instruments used through endoscopes.- I. Electrodes.- II. Forceps, rongeurs, and scissors.- III. Infiltration needles.- IV. Ureteral catheters (Chap. II).- V. Special ureteral catheters.- VI. Ureteral instruments.- 1. Bougies.- 2. Calculus dislodgers.- a) Wire basket.- b) Looped ureteral catheter.- c) Forceps.- 3. Transilluminator.- C. Cystoscopic attachments.- I. Cystoscope holders.- II. Teaching attachment.- III. Photographic attachments.- D. Sources of light for endoscopes.- I. Bulbs.- II. Quartz tube.- III. Batteries.- IV. Electric house current.- E. Care and maintenance of endoscopes.- I. Routine care.- 1. Basic precautions to prevent breakage.- 2. Disinfection.- II. Minor repairs and adjustments.- 1. Light failure.- a) Light bulb.- b) Contact rings of lamp post.- c) Contacts between cord and lamp post.- d) Light cord.- e) Connection of cord to battery terminals.- f) Rheostat.- g) Connections inside battery container.- h) Batteries.- 2. Blurred vision.- F. The cystoscopic room (theatre).- I. Aseptic technique, cleanliness and decorum.- II. Floor.- III. Electric switches.- IV. Darkened room.- V. Anesthetic equipment.- G. Cystoscopic room equipment.- I. Cystoscopic table.- II. Cystoscopic stools.- III. Irrigating fluid supply.- 1. Flask system.- 2. Sterilizer near ceiling.- 3. Pressurized from container on floor.- 4. Water sterilizer—pitcher—jar.- 5. Control of water by foot switch.- H. Endoscopic armamentarium in the armed forces.- II — The cystoscopic procedure.- A. Value of properly performed cystoscopy.- The cystoscopist.- 1. Training.- 2. Dexterity.- B. Indications and contraindications for cystoscopy.- I. Indications.- II. Contraindications.- C. Routine supplies for cystoscopy.- I. Sterile set-up.- II. Lubrication.- III. Drapes.- IV. Media for distending bladder.- 1. Water.- 2. Urine.- 3. Oil.- 4. Air.- D. Preparation of the patient.- I. Prophylactic antibiosis.- II. Bowel preparation.- III. Analgesia.- IV. General or spinal anesthesia.- V. Local anesthesia.- 1. Anesthetic agents.- 2. Application.- 3. Untoward reactions.- E. Position of the patient.- F. Checking of equipment.- I. Instruments.- II. Light bulbs.- G. Introduction of the cystoscope.- I. Information gained from passing the cystoscope.- 1. Stricture.- 2. Elevated posterior lip.- 3. Elongated prostatic urethra.- 4. Residual urine.- II. The causes of difficulties encountered during passage of the cystoscope.- H. Procedures for obtaining clear visualization.- I. Adequate intensity of illumination of the interior of the bladder.- II. Distention of the bladder.- III. Washing debris from the bladder.- IV. Manipulation of the inflow of fluid through the sheath.- V. Proper manipulation of the objective lens.- I. Orientation with different lenses (see Chap. I).- J. Routine bladder examination.- I. Blind spot.- II. Diverticular cavity.- K. Ureteral catheterization.- I. Ureteral catheters.- 1. Tips.- a) Whistle.- b) Olive.- c) Coudé.- d) Filiform.- e) Conical or Garceau and Braasch bulb.- 2. Size.- 3. Flexibility.- 4. Opacity.- 5. Graduation markings.- II. Technique of ureteral catheterization.- III. Manipulations to facilitate ureteral catheterization.- L. Differential renal function.- I. Chromocystoscopy.- 1. Indigocarmine.- 2. Trypan red.- 3. Neoprontosil.- II. Phenolsulphonaphthalein (P. S. P.).- III. Urea clearance.- M. Kidney study (retrograde cystoscopy).- N. Removal of the cystoscope.- O. Cystoscopy hipogastrica.- P. Experimental and practice cystoscopy.- I. Female dogs.- II. Phantom bladder.- III — Postendoscopic care, reactions and complications.- A. Postendoscopic care.- B. Reactions and complications.- C. Prophylaxis of complications.- I. Gentleness.- II. Alertness.- III. Carefulness.- IV. Good judgment.- V. Avoidance of overeagerness.- VI. Definite prophylaxis.- D. Unavoidable reactions and complications.- I. Sensitivity to drugs.- II. Presence of disease.- E. Diagnosis and treatment of reactions and complications.- I. Fever, spasm and pain.- II. Sensitivity to the local anesthetic.- III. Urethral bleeding.- IV. Perforation.- V. Extravasation.- VI. Anuria.- IV — The normal bladder and prostatic urethra.- A. Divisions of the bladder.- B. Vascular pattern.- C. Bladder neck.- D. Trigone and ureteral orifices.- E. Distending the bladder.- F. Bladder tone.- G. Capacity.- H. Variations of the normal bladder.- I. During pregnancy.- II. In the aged.- I. The prostatic urethra.- V — Abnormal ureteral orifices.- A. Congenital anomalies.- I. Agenesis.- 1. Unilateral.- 2. Bilateral.- II. Imperforate.- III. Ectopic location.- 1. Below normal.- 2. Above normal.- IV. Duplication.- 1. Unilateral.- 2. Bilateral and multiple.- V. Abnormal shape and size.- 1. Atresic.- 2. Constricted.- 3. Dilated.- 4. Unusual shape.- B. Acquired abnormalities of size, shape and position.- I. Dilated.- 1. Golf hole.- 2. Impacted calculus.- 3. Incompetent ureterovesical valve.- II. Position higher than normal.- 1. Retracted.- 2. Surgical reimplantation.- 3. Following ureteral meatotomy.- 4. Following resection of bladder tumors.- III. Constricted.- 1. Following surgery.- 2. Following infection.- C. Edema.- I. Calculus.- II. Catheterization.- III. Tumor.- IV. Infection.- D. Protrusion of the ureteral meatus.- I. Calculus.- II. Ureterocele.- III. Tumor.- E. Ulceration.- I. Tuberculous.- II. Nontuberculous.- F. Projections from the ureteral orifice.- I. Blood clot.- II. Calculus.- III. Pus.- IV. Tumor.- V. Prolapse of ureteral mucosa.- G. Propulsions through the ureteral orifice.- I. Bloody jet.- II. Pus.- III. Dye.- VI — Abnormal appearance of mucosal blood vessels in the bladder and posterior urethra.- A. Abnormal grouping of blood vessels.- I. Acute hemorrhagic cystitis.- II. Hunner ulcer.- III. Scars.- B. Decrease in number and size of blood vessels.- I. Chronic cystitis.- 1. Herpes vetularum.- 2. Fibrosis.- II. Anemia.- C. Increase in number and size of blood vessels.- I. Subacute cystitis.- 1. Infection, trauma, chemical irritation.- 2. Allergy.- 3. Endocrine imbalance.- II. Bladder tumor.- III. Prostatic adenoma.- D. Prominent blood vessels.- I. Bladder neoplasm.- II. Large prostatic adenoma.- III. Recurrent prostatic adenoma.- IV. Sclerosis of blood vessels of the bladder mucosa.- V. Varicosities of the bladder.- VII — Bladder contour abnormalities associated with normal mucosa.- A. Abnormalities in bladder size and tone.- I. Contracted (usually hypertonic) bladder.- 1. Congenital.- 2. Fibrosis.- 3. Myogenic hypertonia.- 4. Neurogenic hypertonia.- II. Enlarged (usually hypotonic) bladder.- 1. Congenital.- 2. Myogenic.- 3. Neurogenic.- B. Abnormal contour of ureteral orifices (see Chap. V).- C. Abnormal orifices in the bladder wall.- I. Cellules.- II. Diverticular orifice.- Appearance of interior of diverticulum.- III. Fistulous orifice.- 1. Congenital.- 2. Intestinovesical or from abscess.- 3. Vesicodermal fistula.- 4. Vesicovaginal fistula.- IV. Herniation of the bladder.- V. Rupture through the bladder wall.- D. Depressions in the bladder wall.- I. Cystocele.- II. Following surgical removal of the rectum.- III. Sacculation.- 1. From chronic overdistention.- 2. Following surgical procedures on the bladder.- E. Elevation of the bladder floor.- I. From anteflexed or anteverted uterus.- II. From cervix.- III. From miscellaneous masses posterior to the bladder.- F. Protrusions of the fundus and dome.- I. From the uterus.- II. From extravesical masses.- G. Irregular flat or sessile protrusions.- I. Invasive malignant neoplasms.- 1. Prostatic carcinoma.- 2. Sarcomata.- 3. Squamous cell carcinoma.- II. Nonmalignant neoplasms.- 1. Myogenic and congenital.- 2. Neurofibromata.- 3. Fibromata.- III. Papular cystitis.- H. Pedunculated protuberances.- I. Fibroma and fibroadenoma.- II. Myogenic.- I. Ridges in the bladder wall.- I. Hypertrophy of the interureteric ridge.- II. Trabeculation.- Causes.- III. Undermined or floating trigone.- IV. Postoperative.- J. Septa in the bladder wall.- I. Hourglass.- II. Septate.- III. Multilocular.- VIII — Color abnormalities of the bladder mucosa without change of contour.- A. Red and pink discoloration (predominating).- I. Generalized red discoloration.- Acute cystitis.- II. Patchy areas of red and pink discoloration.- 1. Acute cystitis.- 2. Eechymotic areas.- 3. Cystitis granulomatosa.- 4. Trichomonas vaginalis.- 5. Bilharziasis.- 6. Blastomycosis.- 7. Tuberculosis.- 8. Gonococcus infection of the bladder.- 9. Syphilis.- 10. Stellate areas of red discoloration.- 11. Irregular pink discoloration of the trigone.- 12. Red area in dome.- B. Red, White, light grey and light pink discoloration.- I. White irregular areas.- 1. Alkaline incrusted cystitis.- 2. Irradiation reaction.- 3. Leukoplakia.- 4. Thrush infection.- II. Sloughing tissue.- 1. Severe infection.- 2. Gangrenous cystitis.- 3. Trauma.- III. Ulceration.- 1. Tubercolosis.- 2. Nontuberculous ulcerations.- 3. Actinomycosis.- IV. Invasive malignant neop]asms.- C. Blue discoloration.- Varicosities.- IX — Abnormalities of both color and contour within the bladder.- A. Smooth, regular red protrusions.- I. Benign bladder tumors.- 1. Arising from the bladder wall.- 2. Arising from embryonic rests.- II. Granulomatous tissue.- III. Malignant invasive tumors of the bladder.- 1. Sarcoma and mixed sarcomatous tumors.- 2. Squamous cell carcinoma.- 3. Teratoma.- IV. Malignant extravesical tumors.- B. Smooth red multilobulated protrusions.- I. Edema.- 1. Diffuse edema.- 2. Localized areas of edema.- 3. Bullous edema.- a) Allergy.- b) Amebiasis.- c) Intestinovesical fistula.- d) Indwelling urethral catheter.- e) Invading neoplasm.- II. Neoplasms.- 1. Benign.- a) Chronic cystitis.- b) Cystitis glandularis.- 2. Malignant.- C. Irregular red intravesical protrusions.- I. Neoplasms.- 1. Carcinoma.- 2. Osteogenic sarcoma.- 3. Amyloidosis.- II. Granulation tissue.- 1. Nonspecific infections.- 2. Subacute and chronic specific infections, stones, foreign bodies, neoplasms and trauma.- D. Irregular red and white protrusions.- I. Material causing white discoloration.- 1. Calcareous deposit; sloughing tissue.- 2. Mucopurulent and epithelial exudate.- 3. Miscellaneous.- a) Combination of substances.- b) Gauze sponge.- c) Fragment of bone.- II. Lesions causing red and white protrusions.- 1. Neoplasm.- 2. Severe chronic infections.- E. Red and pink papillary projections.- I. Bullous edema.- II. Papillary tumors.- 1. Papillomata.- 2. Aniline tumors.- 3. Leukoplakia; bilharzia.- 4. Colloid urachal tumors.- 5. Hamartoma.- F. Discolored cystic, vesicular and polypoid elevations.- I. Entamoeba histolytica.- II. Cystitis cystica.- III. Cystitis emphysematosa.- IV. Dermoid cysts and teratoma.- V. Echinococcus disease.- VI. Endometriosis.- VII. Gonococcal infection, healed.- VIII. Hemangioma.- IX. Herpes zoster.- G. Yellow or greyish yellow elevations of the bladder mucosa.- I. Cystitis follicularis.- II. Lipomata.- III. Leiomyomata.- IV. Malakoplakia.- V. Osteoma.- VI. Tubercles.- H. Blue elevations.- I. Varicose veins.- II. Endometriosis.- III. Metastatic melano-epithelioma.- I. Reddish brown elevations.- Lichen planus.- J. Discolored depressions.- I. Lacerations and rupture.- II. Following electrosurgical procedures.- III. Ulceration.- 1. Chronic infections.- a) Tuberculosis.- b) Nontuberculous.- c) Actinomycosis.- 2. Neoplastic.- K. Lesions showing all types of color and contour abnormalities.- I. Vesical bilharziasis.- 1. Hemorrhagic areas.- 2. Edema.- 3. Discolored white areas.- 4. Ulcerations.- 5. Tubercles.- 6. Protrusions.- a) Nodules.- b) Cystic.- c) Papillomata.- 7. Complicating lesions.- 8. Diagnosis.- II. Carcinoma of the bladder.- 1. Variable appearance.- 2. Differential diagnosis.- III. Gangrenous cystitis.- IV. Syphilis.- V. Pemphigus vulgaris.- VI. Vesical tuberculosis.- X — Abnormal bladder contents.- I. Blood clots.- 1. Location.- 2. Identification.- 3. Evacuation.- II. Calculi.- 1. Identification.- 2. Location.- a) Floor.- b) Fundus.- c) Dome.- 3. Number and size.- a) Estimation of size.- 4. Shape and color.- a) Composition in general.- b) Light colored phosphatic.- c) Faceted phosphatic.- d) Brown spiculed (“mulberry”) oxalate.- e) Dark (“Jackstone”) oxalate.- f) Pale yellow to deep brown mixed.- g) Characteristic color.- III. Foreign bodies.- 1. Inserted by patients.- 2. Incrustation.- 3. Bone fragments.- 4. Floating objects.- a) Debris and oil.- b) Paraffin.- c) Wood.- 5. Following medical or surgical procedures.- a) Gauze sponge.- b) Nonabsorbable suture material.- c) Urological equipment.- IV. Shreds of mucus, pus and epithelial cells.- V. Sloughing tissue.- XI — Abnormalities of the bladder neck and posterior urethra in the male.- I. Contracture of the vesical orifice.- 1. Appearance at the margin of the vesical neck.- 2. Appearance from within the bladder.- 3. Appearance from the prostatic urethra.- II. Intrusion into the bladder neck and prostatic urethra.- 1. Median bar.- 2. Median lobe prostatic hypertrophy.- 3. Lateral lobe prostatic hypertrophy.- 4. Ventral lobe prostatic hypertrophy.- 5. Prostatic abscess.- 6. Carcinoma of the prostate.- 7. Carcinoma primary in the mucosa.- 8. Polypi and cysts.- III. Rigidity of the prostatic urethra and bladder neck.- IV. Abnormal dilatation of the vesical orifice.- 1. Congenital defects and neurogenic lesions.- 2. Urinary obstruction.- 3. Prostatic adenoma; postoperative.- V. Post inflammatory fibrosis of the prostatic urethra.- VI. Dilatation of prostatic duct orifices.- Orifice of prostatic diverticulum or abscess.- VII. Abnormalities of the verumontanum.- 1. Congestion and infection.- a) Granulation tissue.- 2. Enlargement.- VIII. Abnormal red discoloration of the mucosa of the prostatic urethra.- IX. Calculi and foreign bodies in the prostatic urethra.- X. Posterior urethral valves.- XI. Interpretation of findings in the prostatic urethra.- 1. Close view.- 2. Distortion due to passage of the endoscope.- XII. Cystoscopy for diagnosis of prostatism.- XII — Abnormalities of the bladder neck and urethra in the female.- I. Contracture of the vesical orifice.- II. Dilatation of the vesical orifice.- III. Increased curvature of the urethra.- IV. Normal urethral mucosa.- V. Fibrosis and stricture of the urethra.- VI. Increased redness of the urethral mucosa.- VII. Irregularities at the bladder neck.- 1. Edema.- 2. Granulations.- 3. Neoplasm.- 4. Polypoid growths.- VIII. Irregularities in the urethra.- 1. Granulations.- 2. Neoplasm.- 3. Polypoid growths.- 4. Sacculation.- IX. Diverticular orifice.- 1. Calculus in diverticulum.- 2. Neoplasm in diverticulum.- X. Periurethral ducts.- XI. Urethral meatus.- XIII — Urethroscopy and miscellaneous endoscopic procedures.- I. Urethroscopy.- 1. Urethroscopes.- 2. Technique of urethroscopy.- 3. Normal urethra.- a) Prostatic.- b) Membranous.- c) Bulbous.- d) Penile.- 4. Abnormal urethral contour.- a) Constriction.- b) Depression, sacculation and dilatation.- c) Intrusions.- 5. Abnormal color of the urethral mucosa.- a) Increased redness.- b) White or light colored areas.- 6. Orifices.- a) Urethral diver...

Dettagli dell'edizione

• Editore: Springer
• Data di pubblicazione: 2012
• Lingua: Inglese
• ISBN 10: 3642865739
• ISBN 13: 9783642865732
• Rilegatura: Copertina flessibile
• Numero di pagine: 308
• Contatto del produttore: ProductSafety@springernature.com; ProductSafety@springernature.com; ; Poststr. 9; Darmstadt; 64293; Germania