First Year Fellows Endoscopy Course (August 4-5)

6-Diagnostic_Colonscopy

Pdf Summary

This document provides information on diagnostic colonoscopy, including indications, contraindications, technique, and troubleshooting. <br /><br />Indications for colonoscopy include screening for asymptomatic individuals at average or high risk, surveillance for those with a history of pathology, and diagnosis of unexplained GI symptoms and signs, GI bleeding, iron deficiency anemia, inflammatory bowel disease, and abnormal imaging of the colon.<br /><br />Contraindications for colonoscopy include perforated intestine, acute diverticulitis, deep ulcerations, severe ischemic necrosis, fulminant colitis, cardiopulmonary decompensation, and inability to tolerate bowel prep.<br /><br />The technique of colonoscopy involves starting with a careful perianal exam, performing a digital rectal examination, and then proceeding with anal intubation. Basic rules of colonoscopy should be followed, such as not advancing the colonoscope without a clear view of the lumen, not advancing if there is resistance, using as little air as possible, keeping the colonoscope lubricated, and paying attention to the patient's level of discomfort.<br /><br />Anatomic landmarks during colonoscopy include the rectum, sigmoid and descending colon, splenic flexure, transverse colon, hepatic flexure, ascending colon, cecum, and terminal ileum.<br /><br />Loop formation and reduction are important aspects of colonoscopy technique. Non-specific abdominal pressure can be used to prevent looping during intubation at specific tip locations.<br /><br />During endoscope withdrawal, it is important to clean the colon, check behind folds using techniques like retroflexion, and be thorough in examining the mucosa.<br /><br />In summary, this document provides a brief overview of diagnostic colonoscopy, including indications, contraindications, technique, and important aspects to consider during the procedure.

Keywords

diagnostic colonoscopy

indications

contraindications

technique

troubleshooting

screening

surveillance

GI symptoms

GI bleeding

anemia