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February 1987, Vol 141, No. 2 >
Article | February 1987

Gastric Acid Aspiration Possible During Flexible Endoscopy Without General Anesthesia-Reply FREE

Donald W. Bendig, MD
Am J Dis Child. 1987;141(2):128-129. doi:10.1001/archpedi.1987.04460020018016.
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In Reply.—Dr Kibelbek is concerned with the potential risk of aspiration of gastric contents utilizing the technique described for removal of blunt esophageal foreign bodies by flexible endoscopy without general anesthesia.1 He attempts to substantiate this fear by making reference to animal studies in which critical values of gastric volume and pH were established.2 I would seriously question the significance of these values in regard to human subjects and avoid making sweeping statements based on this evidence alone.

The ability to perform upper intestinal endoscopy does not necessarily imply the abolishment of the cough and gag reflexes, as stated by Dr Kibelbek. The patients are not rendered unresponsive by the sedation regimen, as was outlined in the "Methods" section of the article.1 The gastric juices and air are aspirated before removal of the endoscope at the end of the procedure, and the patients are placed in

REFERENCES

1 +
Bendig DW:  Removal of blunt esophageal foreign bodies by flexible endoscopy without general anesthesia . AJDC 1986;;140:789-790.
2 +
Greenfield LJ, Singleton RP, McCaffree DR, et al:  Pulmonary effects of experimental graded aspiration of hydrochloric acid . Ann Surg 1969;;170:74-84.
3 +
Tedesco FJ, Goldstein PD, Gleason WA, et al:  Upper gastrointestinal endoscopy in the pediatric patient . Gastroenterology 1976;;70: 492-494.
4 +
Graham DY, Klish WJ, Ferry GD, et al:  Value of fiberoptic gastrointestinal endoscopy in infants and children . South Med J 1978;;71: 558-560.
5 +
Ament ME, Christie DL:  Upper gastrointestinal fiberoptic endoscopy in pediatric patients . Gastroenterology 1977;;72:1244-1248.

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References

1 +
Bendig DW:  Removal of blunt esophageal foreign bodies by flexible endoscopy without general anesthesia . AJDC 1986;;140:789-790.
2 +
Greenfield LJ, Singleton RP, McCaffree DR, et al:  Pulmonary effects of experimental graded aspiration of hydrochloric acid . Ann Surg 1969;;170:74-84.
3 +
Tedesco FJ, Goldstein PD, Gleason WA, et al:  Upper gastrointestinal endoscopy in the pediatric patient . Gastroenterology 1976;;70: 492-494.
4 +
Graham DY, Klish WJ, Ferry GD, et al:  Value of fiberoptic gastrointestinal endoscopy in infants and children . South Med J 1978;;71: 558-560.
5 +
Ament ME, Christie DL:  Upper gastrointestinal fiberoptic endoscopy in pediatric patients . Gastroenterology 1977;;72:1244-1248.

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