- Anoscopy
- Balloon Tamponade for Gastrointestinal Bleeding
- Esophageal Foreign Body Removal
- Gastric Lavage
- Gastrostomy Tube Replacement
- Nasogastric Tube Placement
- Paracentesis
- Rectal Foreign Body Extraction
- Whole Bowel Irrigation

Anoscopy
Rapid Review
- Background
- Use of anoscope to visually inspect the anus, anal canal, and internal sphincter, primarily for the purpose of identifying rectal bleeding.
- Indications
- Evaluation of anorectal symptoms (bleeding, pain, discharge, protrusions, foreign bodies)
- Contraindications
- Imperforate anus, active bleeding. Relative contraindications included severe anal pain or recent surgery.
- Complications:
- Perineal skin/mucosa injury, infection, shearing of hemorrhoidal tissue.
Pearls
Deep Dive

Balloon Tamponade for Gastrointestinal Bleeding
Rapid Review
- Background
- Placement over an orogastric tube with balloon tamponade capabilities designed for the management of esophageal or gastric bleeding. Specifically devices include the sengstaken-blakemore tube, minnesota tube, and linton-nachlas tube
- Indications
- Unstable patient with massive upper GI bleed
- Contraindications
- Recent esophageal or gastric surgery
- Complications
- Esophageal rupture, mucosal ulceration, aspiration
Pearls

Esophageal Foreign Body Removal
Rapid Review
Pearls
Deep Dive

Gastric Lavage
Rapid Review
Pearls
Deep Dive

Gastrostomy Tube Replacement
Rapid Review
Pearls
Deep Dive

Nasogastric Tube Placement
Rapid Review
- Background
- Placement of a tube via the nasogastric route to provide access to the stomach for therapeutic or diagnostic purposes.
- Indications
- Gastric decompression, administration of medication, administration of radiographic contrast, bowel irrigation
- Contraindications
- Recent nasal surgery, severe facial trauma
- Complications
- Pulmonary placement, epistaxis, gagging/vomiting
Pearls

Paracentesis
Rapid Review
- Background
- Insertion of a needle/catheter into the peritoneal cavity to drain ascitic fluid for diagnostic or therapeutic purposes.
- Indications
- Acute onset of ascites, suspected bacterial peritonitis
- Contraindications
- Acute abdomen requiring surgery, severe thrombocytopenia, active bleeding
- Complications
- Hemorrhage, bladder/bowel perforation, vessel laceration, infection, ascites fluid leak
Pearls

Rectal Foreign Body Extraction
Rapid Review
- Background
- Process of removing rectal foreign bodies. Common objects include bottles, vibrators, vegetables, fruit, or balls. May also be caused by drug packing/stuffing
- Indications
- Bedside removal indicated if object is less than 10 cm proximal to anal verge or palpable on digital rectal exam
- Contraindications
- Perforation, peritonitis
- Complications
- Local tissue trauma, tearing of rectal mucosa
Pearls

Whole Bowel Irrigation
Rapid Review
Pearls
Deep Dive
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