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Canadian Journal of Gastroenterology
Volume 21 (2007), Issue 4, Pages 223-225
Original Article

Aspiration in the Context of Upper Gastrointestinal Endoscopy

A Thomson,1 J Tye-Din,1 S Tonga,1 J Scott,2 C Mclaren,2 P Pavli,1 and F Lomas2

1Gastroenterology Unit, The Canberra Hospital, The Australian National University, Canberra, Australia
2Department of Nuclear Medicine, The Canberra Hospital, The Australian National University, Canberra, Australia

Received 5 June 2006; Accepted 26 June 2006

Copyright © 2007 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Pulmonary aspiration is a life-threatening complication of upper gastrointestinal endoscopy, the incidence of which has not been determined. Endoscopy-related aspiration has not been studied in procedures in which patients swallow a radiolabelled potential aspirate immediately before endoscopy and undergo nuclear scanning postprocedure.

METHODS: A pilot study was conducted in which 200 MBq of non-absorbable technetium-99m phytate in 10 mL of water was administered orally to 50 patients who were about to undergo endoscopy. Gamma camera images were obtained to ensure that there had been no aspiration before endoscopy. After endoscopy, a repeat scan was performed. Fluid aspirated through the endoscope was also collected and analyzed for radioactivity using a hand-held radiation monitor.

RESULTS: No evidence of pulmonary aspiration was found in any of the patients studied. The mean estimated percentage of the initially administered radioactivity aspirated through the endoscope was 2.66% (range 0% to 10.3%).

CONCLUSION: The present pilot study confirms earlier observations that clinically significant aspiration in the context of upper gastrointestinal endoscopy is uncommon. The incidence of aspiration may, however, be different in acutely bleeding patients undergoing endoscopy. For logistic reasons, this group could not be studied.