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Colonos

Colonoscopy is an endoscopic procedure for examining the colon and terminal ileum, with types including diagnostic, therapeutic, screening, and surveillance. Common indications involve gastrointestinal symptoms, colorectal cancer screening, and therapeutic interventions. Contraindications and potential complications exist, necessitating careful preparation and sedation for the procedure.

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29 views2 pages

Colonos

Colonoscopy is an endoscopic procedure for examining the colon and terminal ileum, with types including diagnostic, therapeutic, screening, and surveillance. Common indications involve gastrointestinal symptoms, colorectal cancer screening, and therapeutic interventions. Contraindications and potential complications exist, necessitating careful preparation and sedation for the procedure.

Uploaded by

drsamal1999
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Colonoscopy Overview

Definition

Colonoscopy is an endoscopic procedure that allows direct visualization and examination of


the entire colon and distal part of the terminal ileum using a flexible fiber-optic or video
endoscope inserted through the rectum.

Types of Colonoscopy

1. Diagnostic Colonoscopy:
o Performed to investigate gastrointestinal symptoms or abnormalities.
2. Therapeutic Colonoscopy:
o Includes interventions such as polypectomy, biopsy, hemostasis, stent
placement, or dilation of strictures.
3. Screening Colonoscopy:
o Used in asymptomatic individuals, typically for colorectal cancer
screening (especially in adults aged ≥45-50).
4. Surveillance Colonoscopy:
o Follow-up in patients with previous colorectal cancer, polyps, or IBD.

Common Indications

1. Diagnostic:
o Lower GI bleeding (melena, hematochezia)
o Change in bowel habits (constipation, diarrhea)
o Unexplained iron deficiency anemia
o Chronic abdominal pain
o Suspected IBD or colorectal cancer
2. Screening/Surveillance:
o Age-based colorectal cancer screening
o Personal/family history of colorectal polyps or cancer
o Surveillance in IBD (Crohn’s or Ulcerative Colitis)
3. Therapeutic:
o Polypectomy
o Hemostasis of bleeding lesions
o Foreign body removal
o Stent placement (e.g., obstructive colorectal cancer)
Contraindications
Absolute Contraindications:

• Suspected or confirmed perforation of the colon


• Fulminant colitis/toxic megacolon (e.g., severe UC flare)
• Peritonitis
• Acute myocardial infarction or unstable cardiopulmonary status

Relative Contraindications:

• Poor bowel preparation


• Recent colonic surgery
• Severe coagulopathy or anticoagulation (unless reversible)
• Severe diverticulitis
• Pregnancy (depends on indication and gestational age)

Potential Complications
Early (During or within 24h):

• Perforation (0.1–0.2%)
• Bleeding (especially post-polypectomy)
• Cardiorespiratory events (due to sedation – hypoxia, hypotension, arrhythmias)
• Infection (rare)
• Abdominal pain or distention due to air insufflation

Late (After 24h to several days):

• Delayed bleeding (especially after polypectomy or biopsy)


• Post-polypectomy syndrome: transmural burn without perforation causing
pain, fever, leukocytosis
• Bowel obstruction (rare, usually due to stricture formation or edema)
• Infection/sepsis (e.g., from bacteremia in high-risk patients)

Preparation & Sedation

• Bowel preparation: polyethylene glycol or sodium phosphate the day before


• Sedation: usually conscious sedation (e.g., midazolam + fentanyl), sometimes
deep sedation or general anesthesia
• Consent: discuss risks, benefits, and alternatives

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