First Year Fellows Endoscopy Course (July 28-29) | 2024-9-Therapeutic_Colonoscopy

9-Therapeutic_Colonoscopy_2024

Pdf Summary

The document provides an overview of therapeutic colonoscopy for lower gastrointestinal (GI) bleeding, including definitions, etiologies, and management guidelines. Lower GI bleeding is described as bleeding from a source distal to the ileocecal (IC) valve lasting more than 3 days, potentially causing hemodynamic instability and anemia. Etiologies include diverticular bleeding, ischemic colitis, angioectasia, hemorrhoids, and more.<br /><br />Colonoscopy is highlighted as the preferred diagnostic and therapeutic procedure for acute lower GI bleeding, offering advantages such as precise localization and therapy options. Various techniques like injection therapy, thermal therapy, and mechanical therapy can be employed during colonoscopy for managing conditions like polypectomy and vascular lesions. Additionally, the importance of proper preparation, technique, and post-polypectomy considerations are emphasized to minimize complications like bleeding and perforation.<br /><br />The text stresses the role of endoscopic procedures in diagnosing and managing acute lower GI bleeding, highlighting the use of colonoscopy to identify and treat conditions like diverticular bleeding and AVM bleeding. It also discusses non-endoscopic management options like tagged RBC scans and angiotherapy for unstable patients. Practical tips for performing polypectomy, including different techniques and considerations, are outlined to ensure successful outcomes.<br /><br />In conclusion, the document emphasizes the significance of thorough management of acute lower GI bleeding through colonoscopy, proper technique application, and awareness of potential complications. It reiterates the importance of proficiency in endoscopic procedures and decision-making to achieve successful outcomes and prevent adverse events.

Keywords

therapeutic colonoscopy

lower gastrointestinal bleeding

management guidelines

diverticular bleeding

ischemic colitis

angioectasia

hemorrhoids

injection therapy

thermal therapy

mechanical therapy