Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Urethral catheterization
- Percutaneous suprapubic catheterization
- Vascular access
- Arterial cannulation
- Central line insertion
- Lumbar puncture
- Airway
- Chest drain insertion
- Thoracocentesis
- Pericardiocentesis
- Nasogastric tubes
- Abdominal paracentesis
- Diagnostic peritoneal lavage (DPL)
- Rigid sigmoidoscopy
- Proctoscopy
- Oesophago-gastro-duodenoscopy (OGD)
- Endoscopic retrograde cholangio-pancreatography (ERCP)
- Colonoscopy and flexible sigmoidoscopy
- Local anaesthesia
- Regional nerve blocks
- Sutures
- Bowel anastomoses
- Skin grafts and flaps
- Principles of laparoscopy
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Colonoscopy and flexible sigmoidoscopy
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Urethral catheterization
- Percutaneous suprapubic catheterization
- Vascular access
- Arterial cannulation
- Central line insertion
- Lumbar puncture
- Airway
- Chest drain insertion
- Thoracocentesis
- Pericardiocentesis
- Nasogastric tubes
- Abdominal paracentesis
- Diagnostic peritoneal lavage (DPL)
- Rigid sigmoidoscopy
- Proctoscopy
- Oesophago-gastro-duodenoscopy (OGD)
- Endoscopic retrograde cholangio-pancreatography (ERCP)
- Colonoscopy and flexible sigmoidoscopy
- Local anaesthesia
- Regional nerve blocks
- Sutures
- Bowel anastomoses
- Skin grafts and flaps
- Principles of laparoscopy
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Summary
Definitions
The colonic mucosa is examined with and therapy delivered through, a flexible endoscope (also see Chapter on OGD). A limited examination of the sigmoid and descending colon, usually to the splenic flexure (approximately 60 cm with a straight scope), is termed ‘flexible sigmoidoscopy’. With full ‘bowel prep’ and sufficient dexterity ‘colonoscopy’ can be performed when a scope is passed to the caecum, allowing access to the entire colonic mucosa, and the terminal ileum if necessary.
Indications
COLONOSCOPY
▪ Iron deficiency anaemia
▪ Blood in the stool or rectal bleeding
▪ Altered bowel habit (diarrhoea or constipation)
▪ Significant, unexplained weight loss, accompanied by gastrointestinal symptoms
▪ A family history of colon cancer
▪ A history of previous colon polyps or colon cancer
▪ Cancer screening in people with ulcerative colitis
▪ To assess inflammatory bowel disease
▪ Chronic, unexplained abdominal pain.
FLEXIBLE SIGMOIDOSCOPY
This is a limited examination and should not be performed when there is a significant chance of missing serious proximal pathology (50% of all colon cancers are proximal to the splenic flexure), hence indications are limited. Senior advice/local guidelines should be sought if you are not sure which examination to book. The common indications are:
▪ Minimal bright red rectal bleeding
▪ As a screening test in asymptomatic people to detect colon polyps or colon cancer
▪ Persistent diarrhoea with no alarm symptoms e.g. in diagnostic workup for irritable bowel syndrome
▪ After radiation treatment to the pelvis when a patient has lower gastrointestinal symptoms
▪ To assess inflammatory bowel disease.
- Type
- Chapter
- Information
- Hospital SurgeryFoundations in Surgical Practice, pp. 659 - 665Publisher: Cambridge University PressPrint publication year: 2009