First Year Fellows Endoscopy Course ( August 6-7)

6-Diagnostic_Colonscopy

Pdf Summary

The ASGE First Year Fellows Endoscopy Course provides an overview of diagnostic colonoscopy, including indications, contraindications, technique, and troubleshooting. <br /><br />Indications for colonoscopy include screening for average or high-risk individuals, surveillance for those with a history of pathology, and diagnosis for unexplained GI symptoms, GI bleeding, iron deficiency anemia, IBD, 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 colonoscopy technique starts with a careful perianal exam and digital rectal examination. Basic rules of colonoscopy include not advancing the scope without a clear view of the lumen, pulling back when in doubt, not advancing if there is resistance, using as little air as possible (considering CO2 for insufflation), keeping the scope lubricated, and paying attention to the patient's comfort level. <br /><br />Anatomy landmarks during colonoscopy include the rectum, sigmoid, descending colon, splenic flexure, transverse colon, hepatic flexure, ascending colon, cecum, and terminal ileum. Tips for successful terminal ileal intubation include deflating, hooking the scope tip between lips of the ileocecal valve, and using the bow and arrow sign. <br /><br />Loop formation and reduction techniques are important for successful colonoscopy. Abdominal pressure can be applied at specific areas to reduce looping during intubation. <br /><br />During scope withdrawal, it is important to clean the colon, check behind folds using retroflexion, and be thorough in examining the mucosa. Take time to navigate folds using tip deflection, rotation/torque, and retroflexion. <br /><br />In summary, the ASGE First Year Fellows Endoscopy Course highlights the indications, contraindications, technique, and troubleshooting of diagnostic colonoscopy. It emphasizes the importance of proper scope insertion, loop reduction, and thorough examination during scope withdrawal.

Keywords

ASGE First Year Fellows Endoscopy Course

diagnostic colonoscopy

indications

contraindications

technique

troubleshooting

screening

surveillance

GI symptoms

anatomy landmarks