Background
Esophagogastroduodenoscopy (EGD) is a procedure during which a small flexible endoscope is introduced through the mouth (or, with smaller-caliber endoscopes, through the nose) and advanced through the pharynx, esophagus, stomach, and duodenum.
An enteroscope, a longer endoscope, can be introduced beyond the ligament of Treitz into the jejunum.
EGD is used for both diagnostic procedures and therapeutic procedures. Most modern endoscopes now use a video chip (charged coupled device) for better imaging, as opposed to the older endoscopes, in which fiber optics are used for image transmission. (See the images below.)
Esophagogastroduodenoscopy (EGD). Normal vocal cords as seen prior to entering the esophagus during video EGD.
Esophagogastroduodenoscopy (EGD). Normal lower esophageal sphincter seen during EGD.
Esophagogastroduodenoscopy (EGD). Normal pylorus seen during EGD.
Esophagogastroduodenoscopy (EGD). Normal duodenum in the area of the ampulla, as seen during EGD.
In the United States, EGD is usually performed while the patient is under conscious or moderate sedation, though it can be performed with only topical anesthesia (as is common practice in Europe and Asia). General anesthesia is often used in a selected group of patients who are difficult to sedate because of chronic narcotics intake.
The procedure is usually performed in a dedicated endoscopy unit in the hospital or outpatient office setting but can also be done in the emergency department (ED), the intensive care unit (ICU), or the operating room (OR) by using portable endoscopy carts. With the aid of various types of equipment and endoscopes, endoscopic ultrasonography (EUS), endoscopic retrograde cholangiopancreatography (ERCP), and small-bowel enteroscopy can also be performed.