First Year Fellows Endoscopy Course (July 29 - 30)

8-Therapeutic_Colonoscopy

Pdf Summary

The document discusses different aspects of therapeutic colonoscopy, including the management of lower gastrointestinal bleeding, polypectomy techniques and complications, and colonoscopic decompression. <br /><br />The definition of acute lower gastrointestinal bleeding is a source of bleeding distal to the ligament of Treitz, with a duration of less than three days. The document also lists various etiologies of lower GI bleeding, such as diverticular bleeding, ischemic colitis, angioectasia, hemorrhoids, colorectal neoplasia, and more.<br /><br />Management of lower GI bleeding includes urgent colonoscopy, which allows for precise localization, possible therapy, and a diagnostic yield of 45-90%. The document also mentions non-endoscopic management options like tagged RBC scans, multidetector helical CT angiography, angiography, and surgery.<br /><br />Polypectomy techniques are discussed, including cold biopsy, cold snare, hot snare/electrocautery, hot biopsy, and EMR with submucosal "saline lift." The document provides details on the preparation, technique, and considerations for snare polypectomy.<br /><br />Complications of colonoscopy, such as bleeding, perforation, retroperitoneal abscess, and subcutaneous emphysema, are mentioned. Post-polypectomy complications, such as bleeding and post-polypectomy coagulation syndrome, are also discussed.<br /><br />The document covers the topic of colonic decompression, including indications, techniques for unprepared colons, and the use of decompression tubes.<br /><br />Overall, the document provides an overview of therapeutic colonoscopy and its various aspects, including the management of lower GI bleeding, polypectomy techniques, and complications.

Keywords

therapeutic colonoscopy

lower gastrointestinal bleeding

polypectomy techniques

complications

colonoscopic decompression

acute lower gastrointestinal bleeding

diverticular bleeding

ischemic colitis

angioectasia

hemorrhoids