Colonoscopy.pptx

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Colonoscopy



• A colonoscopy is an exam of the lower partof the gastrointestinal tract, the colon or

large intestine (bowel).• Colonoscopy is a safe procedure that

provides information other tests may notbe able to give.



DEC!"#$"%&

• Colonoscopy allows inspection of the mucosa of theentire colon, ileocecal valve ' terminal ileum usinga exible beroptic colonoscope inserted throughthe anus ' advanced to the terminal ileum.



• $he colonoscope is a multichannel instrument thatallows viewing of the gastrointestinal (*") tract lining,

insu+ation of air, aspiration of uid, obtaining oftissue biopsy samples ' passage of a laser beam forobliteration of tissue and control of bleeding.

• ucosal surfaces of the lower *" tract are examinedfor ulcerations, polyps, chronic diarrhea, hemorrhagic

sites, neoplasms ' strictures.



• During the procedure, tissue samples may

be obtained for cytology ' sometherapeutic procedures may be performed(such as excision of small tumors orpolyps, coagulation of bleeding sites, andremoval of foreign bodies).



"&D"CA$"%&

pecic

Diagnostic

$herapeutic



SPECIFIC INDICATIONS

• "nvestigation of overt or occultbleeding

• Abnormal radiological imaging

• "rritable bowel syndrome

• "nammatory bowel disease

•

Colorectal cancer screening• #olypectomy surveillance



DIAGNOSTICINDICATIONS

• !ectal bleeding (overt-occult)

• "ron deciency anemia

• Chronic diarrhea

• &ew-worsening constipation

• Abnormality on C$ scan, #E$ scan or barium enema

• urveillance in chronic ulcerative or Crohns colitis

• urveillance after removal of neoplasm

• /nexplained abdominal-pelvic pain

• C!C screening• "diopathic colitis0 determine of disease extent-activity

and-or response to therapy

• "ntraoperative identication of previously identied lesionnot apparent at surgery



THERAPEUTICINDICATIONS

• !emoval of foreign body

• Excision of polyp

• $reatment of acute or chronic colonic bleeding

• Decompression of colonic pseudo1obstruction• Decompression of volvulus

• "ntramucosal in2ection of drug

• Dilatation-stenting of symptomatic colonicstricture (either begin-malignant)

• ar3ing (tattooing) site of lesion beforesurgical resection







CONTRAINDICATIONS

ABSOLUTE

• $oxic megacolon• 4ulminant colitis• 4ree colonic perforation• #atient refuses consent• #atient cannot cooperate

with the procedure

RELATIVE

• Acute diverticulitis• "nade5uate colonic

cleansing• !ecent ", pulmonary

embolism or clinicalinstability for any othercause

• "mmediately post1colonicsurgery (recent

anastomosis)• evere coagulopathy



NORMAL FINDINGS

• &ormal intestinal mucosa with noabnormalities of structure, function,or mucosal surface in the colon or

terminal ileum.



• ample image set showing a colonoscopy of a normal colon.



ABNORMAL FINDINGS

• 6leeding sites

• 6enign lesions

• 6owel distention

• 6owel infection or inammation

• Colon cancer

• Crohns disease

• Colitis

• Diverticula

• 4oreign bodies

• 7emorrhoids

• #olyps

• #roctitis

• $umors

• 8ascular abnormalities



9eft0 !ectal variceal active bleeding (arrow) treated withband ligation.!ight0 4ollowing immediate cessation of bleeding, thebleeding point is seen at the apex of the banded varix(arrow).





• Example of colonic stenosis from a benignprocess (left) or a malignant one (right).



• Erythe!to"s "cos! in the colon, dened as an increased redness of the mucosa, due toan increase in its hemoglobin content because of increased blood ow (left), which should bedistinguished from a con#este$ "cos!, dened as a swelling of the mucosa due to anincrease in the mass of the mucosa, occuring most often in association with an inammatory

process where permeability of cell membranes is altered ' the extracellular osmolarity ismodied (right).



• Erosions of the rectal mucosa (left) andtypical aphthae (right).



• imilar elements describable by the same aggregate of words (ulcers,erythema, congested mucosal) can represent di:erent clinicaldiagnoses (left, ulcerative colitis; right, Crohns disease). tructuredlanguage manages this by following the descriptor words with theprobable specic diagnosis.









A depressed lesion with marginal elevation (type ""c < ""a) inthe transverse colon, = mm in diameter.(a) %rdinary colonoscopic view.

(b) Chromoendoscopy with indigo carmine.





!E4E!E&CE

• Colonoscopy0 #rinciples and #ractice,>nd Edition, ?. D. @aye, @iley6lac3well

• American College of urgeon,urgical #atient Education,www.facs.org-patienteducation

http://www.facs.org/patienteducation

http://www.facs.org/patienteducation

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Colonoscopy.pptx

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