First Year Fellows Endoscopy Course (August 7 - 8)

6-Diagnostic_Colonscopy

Pdf Summary

The ASGE First Year Fellows Endoscopy Course covers the topic of diagnostic colonoscopy. The document outlines the indications, contraindications, technique, and trouble-shooting for this procedure.<br /><br />Indications for colonoscopy include screening for individuals at average or high risk, surveillance for patients with a history of pathology, and diagnosis for patients with unexplained GI symptoms, GI bleeding, iron deficiency anemia, IBD, or 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 document also provides information on the technique of colonoscopy. It emphasizes the importance of starting with a careful perianal exam, including a digital rectal examination and prostate examination in males. Basic rules of colonoscopy include not advancing the colonoscope without a clear view of the lumen, pulling back when in doubt, not advancing if there is resistance, using as little air as possible, and keeping the colonoscope lubricated.<br /><br />The document highlights the importance of paying attention to the patient's level of discomfort and using techniques such as CO2 insufflation and water immersion to minimize discomfort. It also provides information on anatomic landmarks, loop formation, and loop reduction techniques during colonoscopy.<br /><br />The document concludes with a summary of key points, including the importance of reviewing procedural indications and risks/benefits, being aware of body position during the procedure, using water immersion, position changes, and abdominal pressure during scope insertion, thorough scope withdrawal, and taking time to be methodical and navigate folds during the procedure.

Keywords

diagnostic colonoscopy

indications

contraindications

technique

trouble-shooting

screening

surveillance

GI symptoms

GI bleeding

IBD