colonoscopy

Colonoscopy




Colonoscopy is a diagnostic and therapeutic method that allows accurate watching of colon mucosa, evaluating visual changes, taking a specimens for histopathological examination and removing of small pathological structures (e.g. polyps). To perform the colonoscopy is used a special type of endoscope called ‘colonoscope’ (this is a thin, flexible instrument with a camera that sends images to a monitor). The patient should be gear up for colonoscopy: 1-2 days before the planned procedure the patient starts a liquid diet with taking laxatives (e.g. phosphates). Purifying enema should be performed shortly before colonoscopy. The examination is unpleasant and painful - it is recommended to perform it with anesthesia (general or sedation). Time of the procedure is varied - the more difficult cases may exceed half an hour.


Types


We can distinguish a few types of the colonoscopy based on a range of procedure: anoscopy (examination of the anal and final rectum) , rectoscopy (rectal examination), rectoromanoscopy (examination of the distal part of the sigmoid colon), sigmoidoscopy (distal part of colon and sigmoid), rectosigmoidoscopy (end of the rectum and sigmoid colon) and colonoscopy (examination of complete colon).


Indications


The indication to perform a colonoscopy can be classified into two groups:

1. Therapeutic (small endoscopic procedures): polypectomy, preventing bleeding from abnormal structures (tumors, ulcers, vascular malformations), pulling foreign bodies out, stenoses dilatation, decompression of the worsening ulcerative colitis (megacolon toxicum).

2. Diagnostic (medical indication or screening): suspected of: colorectal cancer, ulcerative colitis, Crohn's disease, inflammatory bowel disease, absorption disorders; diarrhea of unknown origin, gastrointestinal bleeding suspicion (anemia), weight loss and screening of the population (early-stage colorectal cancer).

Contraindications


Peritonitis (abdominal tension and painful abdominal palpation), pregnancy (second and third trimester), coagulation disorders, severe heart disease (heart failure in advanced stage, unstable coronary artery disease), severe pulmonary disease, acute respiratory failure, worsening inflammatory bowel disease.

Complications


(less than 1%): perforation of the gastrointestinal tract and severe bleeding.

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Endoscopic video case: a 86/M with triple vessel disease + post PTCA with CCF-severe LVD, was admitted with bleeding PR. A colonoscopy was done - showed a short pedunculated polyp of <20mm at 25cms...

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How to do the best and fastest colonoscopy in less than 2 minutes. 

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Clinical video case: melanosis coli is a benign condition that causes black or brown discoloration of the colon wall. It usually occurs as a result of using anthraquinone laxatives. People with melanosis...

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Clinical video case: LST removed in the right colon. NBI imaging revealed no worrisome endoscopic features. The polyp was removed successfully using Endoscopic Mucosal Resection technique. HIstopathology...

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Video demonstrating (*brand hidden*) durability in screening colonoscopy in visualizing and resecting colon polyps.

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Video case: endoscopic removal of pedunculate polyp.

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73 years old female who presented with diarrhea for 2 months in June 2019. Colonoscopy: Villous polyp of 4 cm in the rectum. Partnership with http://www.eus-endo.org. 

SAGES Flexible Endoscopy Livestream - Endoscopy...

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The webinar contains basic information about gastrointestinal endoscopy.