Department of Gastroenterology, Kitasato University of Medicine, Sagamihara, Japan,
Department of Gastroenterology, Yuri Kumiai General Hospital, Akita, Japan,
Digestion. 2024;105(4):291-298. doi: 10.1159/000539318. Epub 2024 May 14.
Esophagogastroduodenoscopy (EGD) requires adequate air infusion. However, cases of poor gastrointestinal wall extension due to frequent eructation have been reported. Sufficient gastrointestinal wall extension can be achieved by applying cricoid pressure during EGD. Herein, we evaluated the frequency of cases with poor gastrointestinal wall extension and the efficacy and safety of applying cricoid pressure during EGD.
This interventional study included patients who underwent EGD between January 2020 and December 2020 at the JA Akita Koseiren Yuri Kumiai General Hospital. Cases wherein folds of the greater curvature of the upper gastric body were not sufficiently extended during EGD were considered to have poor gastrointestinal wall extension. In such cases, air infusion was performed while applying cricoid pressure. This procedure was considered effective when gastric wall extension was achieved.
A total of 2,000 patients were enrolled and underwent upper gastrointestinal endoscopy; however, five were excluded because of upper gastrointestinal tract stenosis. Observation of gastric wall extension of the greater curvature in the upper gastric body with normal air insufflation was difficult in 113 (5.7%) cases. Applying cricoid pressure was effective in 93 (82.3%) patients with poor gastric wall extension. Sufficient gastric wall extension was achieved within an average of 12.8 s in cases where cricoid pressure application was effective. No adverse events were associated with cricoid pressure application.
Cricoid pressure application for patients with poor gastric wall extension during EGD is useful for ensuring a sufficient field of view during observation of the gastric body.
食管胃十二指肠镜检查（EGD）需要充足的空气注入。然而，由于频繁呃逆，已报道存在胃肠道壁扩张不佳的情况。在 EGD 期间施加环状软骨压力可充分扩展胃肠道壁。在此，我们评估了胃肠道壁扩张不佳的发生率以及在 EGD 期间施加环状软骨压力的效果和安全性。
这是一项干预性研究，纳入了 2020 年 1 月至 2020 年 12 月期间在 JA 秋田县 Koseiren Yuri Kumiai 综合医院接受 EGD 的患者。在 EGD 期间，若胃体上部大弯的褶皱未充分伸展，则认为胃肠道壁扩张不佳。在这种情况下，在施加环状软骨压力的同时进行空气注入。当胃壁扩张达到预期时，认为该程序有效。
共有 2000 名患者接受了上消化道内镜检查，但因上消化道狭窄而排除了 5 例。在正常空气注入的情况下，观察胃体上部大弯的胃壁伸展较为困难，有 113 例（5.7%）。在 113 例胃肠道壁扩张不佳的患者中，施加环状软骨压力有效。在环状软骨压力施加有效的情况下，平均 12.8 秒内即可获得足够的胃壁扩张。环状软骨压力施加无不良事件发生。
对于 EGD 期间胃肠道壁扩张不佳的患者，施加环状软骨压力有助于确保胃体观察时获得足够的视野。
