Colonoscopy Procedure Guide PDF

COLONOSCOPY 1. What is it? 2. Indications 3. Contraindications 4. Preparation 5. Diagnostic Procedures 6. Theraputic Procedures  COLONOSCOPY- Introduction 1. Inserting flexible long colonoscope to different 5.Proper training and expe...

COLONOSCOPY 1. What is it? 2. Indications 3. Contraindications 4. Preparation 5. Diagnostic Procedures 6. Theraputic Procedures  COLONOSCOPY- Introduction 1. Inserting flexible long colonoscope to different 5.Proper training and experience are parts of large bowel up-to cecum through anal necessary for correct diagnosis. orifice. While withdrawing this scope out, you have to look for any pathology. 6. The diagnostic spectrum of colonoscopy encompasses not only macroscopic assessment 2. Experienced examiner can now successfully reach of the condition of the mucosa, but also the the cecum in 98% of patients. possibility of collecting a targeted biopsy sample and, more recently, the use of dye 3.Difficulties can be posed by a mobile and spraying technique and magnification. elongated sigmoid colon or transverse colon as well as by postoperative intestinal fixations and other 7. Colonoscopy is a technically demanding adhesions. examination procedure with a high clinical yield combined with the capability of 4.Examination generally takes around 30 minutes. therapeutic intervention. Because of painful nature of this procedure you should try to finish the procedure as early as possible.  COLONOSCOPY- Indications  Constipation  Diarrhea  Abdominal pain  Bleeding per rectum, unexplained anemia, weight loss  Postpolypectomy surveillance  Prevention/aftercare colorectal carcinoma  Pathological thickening of the colon wall detected by other A Universal cord and plug imaging procedures B Instrument control head,  Primary tumor search with C Insertion tube metastasizing malignancy. Simbionix computer simulator COLONOSCOPY- Contra Indication Contra Indications Complications and Risks  Perforated intestine  Risk of perforation  Acute diverticulitis  Injury to blood vessels causing bleeding  Deep ulcerations  Infection  Severe ischemic necroses  Comparing diagnostic and therapeutic  Fulminant colitis colonoscopy, more complications arise  Cardiopulmonary from therapeutic measures, such as decompensation polypectomies  COLONOSCOPY- Preparation  Emptying the contents of the  The day of the colonoscopy procedure — As colon is a key requirement for a on the previous day, clear liquid foods only successful colonoscopy. If the  Don't eat or drink anything two hours bowel prep isn't up to par, before the procedure polyps and lesions can be  Now you can give either PEG- Poly missed Ethylene Glycol or Sodium Picosulphate-  A few days before the Fleet enema colonoscopy procedure- Start  Dissolve one pocket of anyone of this in two eating a low-fiber diet Litres of fluid and ask patient to consume  The day before the colonoscopy  Patient will purge several times within few procedure - Don't eat solid foods hours so that the bowel will get cleaned. and have clear liquids.  Can be done under IV sedation of midazolam/fentanyl or propofol COLONOSCOPY- Preparation COLONOSCOPY- Preparation  COLONOSCOPY Five basic rules of colonoscopy  1. Do not advance the endoscope without a clear view of the lumen.  2. Do not advance the endoscope if there is any resistance.  3. When in doubt, pull back.  4. Use as little air as possible and as much air as necessary.  5. Pay attention to patient’s pain reaction.  COLONOSCOPY  Splenic flexure with luminal impression,  Triangular configuration shimmering of spleen. and evenly spaced haustration.  Relatively straight path, oval lumen, and  Ascending colon toward evenly spaced the 7-o’clock position. haustrations.  The ileocecal valve, seen as a yellowish,thickened  Lumen cannot be seen at fold, is on the lower edge of about the 7-o’clock position the lumen but can presumed, in part due to shadowing  Base of the cecum  Appendix orifice in the center  Roomy lumen  Terminal ileum: velvety  Valves of Houston mucosal surface and lacking  Typical submucosal haustrations vascular pattern  COLONOSCOPY Diagnostic Procedures DIVERTICULOSIS DIVERTICULITIS POLYPS POLYPOSIS  CARCINOMA- COLON/RECTUM IBD- Crohn’s & Ulcerati Colitis Angiodysplasia & Radiation Colitis Pseudomembranous & Ischemic Colitis  COLONOSCOPY Therapeutic Procedures SNARE POLYPECTOMY  Endoscopic Mucosectomy Steps in mucosal resection of broad-based polyps using piecemeal resection technique  SEMS- For Malignant Stricture Placement of metal stents combined with balloon dilation or bougienage Hemostasis in Colorectal Pathologies Injection Gold Probe Hemostasis in Colorectal Pathologies Coagulation of an angiodysplasia using APC (ERBE) Hemostasis in Colorectal Pathologies Endoscopic hemoclip application  Removing Foreign Bodies  Removing Foreign BodiesColonoscopic removal of Drug pouches- from a bodypacker