Gastroenterology Book

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Colon Cancer Screening with ColonoscopyAka: Colonoscopy

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  1. See Also
    1. Colonoscopy Intervals for Colon Cancer Screening
    2. Colon Cancer Risk Factors
  2. Efficacy
    1. Identifies up 95% of Colon Cancer
    2. Efficacious and reduces mortality
    3. Preferred over other Colon Cancer screening modalities
    4. Reference
      1. Mandel (1993) N Engl J Med 328:1365
      2. Lieberman (2000) N Engl J Med 343:207
  3. Interpretation: Criteria for a high quality colonoscopy
    1. Minimal fecal residue following colon preparation
    2. Colonoscopy reaches the cecum
    3. Withdrawal time from cecum to rectum is 6 minutes or more
    4. Complete removal of identified polyps (not piecemeal excision)
    5. Rex (2002) Am J Gastroenterol 97:1296
  4. Adverse Effects
    1. Minor common adverse effects
      1. Adverse effects of preparation medications
      2. Adverse effects of Sedation
    2. Serious common adverse effects
      1. Perforations: 1 in 500-3000
        1. Rectosigmoid: 66%
        2. Cecal: 13%
        3. Ascending Colon: 7%
        4. Transverse Colon: 7%
        5. Descending Colon: 7%
      2. Major Bleeding: 1 in 1000
        1. Most common with biopsy or lesion excision
        2. May occur up to 2 weeks after colonoscopy
    3. Uncommon
      1. Splenic trauma
      2. Vasovagal reaction
      3. Endocarditis
    4. Rare
      1. Sepsis
  5. Findings: Polyps
    1. See Colonic Polyps
  6. Management: Suspected colonoscopic perforation
    1. Indications for immediate laparotomy
      1. Peritoneal signs
      2. Unreliable patient or comorbid conditions
      3. Large defect
      4. Poor bowel preparation
    2. Evaluation of stable, reliable patient
      1. Step 1: Obtain upright abdominal XRay
        1. Laparotomy for Free air
      2. Step 2: Obtain CT Abdomen
        1. Laparotomy for large perforation
      3. Step 3: Observe
        1. Indications
          1. Negative upright abdomen
          2. Negative CT or contained perforation on CT
        2. Conservative protocol
          1. Patient kept NPO on intravenous fluids
          2. Prophylactic antibiotics
          3. Serial exams, XRays, and White Blood Cell count
        3. Laparotomy Indications
          1. Clinical deterioration
          2. Increased White Blood Cell count
  7. References
    1. Kavic (2001) Am J Surg 181:319

colonoscopy (C0009378)

Definition (MSH)Endoscopic examination, therapy or surgery of the luminal surface of the colon.
Definition (NCI)(ko-lun-AHS-ko-pee) An examination of the inside of the colon using a thin, lighted tube (called a colonoscope) inserted into the rectum. If abnormal areas are seen, tissue can be removed and examined under a microscope to determine whether disease is present.
Definition (NCI)Endoscopic examination of the luminal surface of the colon.
ConceptsDiagnostic Procedure (T060)
ICD945.23
EnglishColonoscopies, colonoscopy, Endoscopic examination of colon, Endoscopy of colon, Endoscopy of the Colon, Lower gastrointestinal tract examination
FrenchColoscopie, Examen pour le tractus digestif inferier
ItalianColonscopia, Esame del tratto digestivo inferiore
Spanishcolonoscopia, endoscopia del colon
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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