2. 1. What is it?
2. Indications
3. Contraindications
4. Preparation
5. Diagnostic Procedures
6. Theraputic Procedures
COLONOSCOPY
3. 1.Inserting flexible long colonoscope to different
parts of large bowel up-to cecum through anal
orifice. While withdrawing this scope out, you have
to look for any pathology.
2.Experienced examiner can now successfully reach
the cecum in 98% of patients.
3 .Difficulties can be posed by a mobile and
elongated sigmoid colon or transverse colon as well
as by postoperative intestinal fixations and other
adhesions.
4.Examination generally takes around 30 minutes.
Because of painful nature of this procedure you
should try to finish the procedure as early as
possible.
COLONOSCOPY- Introduction
5.Proper training and experience are
necessary for correct diagnosis.
6.The diagnostic spectrum of colonoscopy
encompasses not only macroscopic assessment
of the condition of the mucosa, but also the
possibility of collecting a targeted biopsy
sample and, more recently, the use of dye
spraying technique and magnification.
7.Colonoscopy is a technically demanding
examination procedure with a high clinical
yield combined with the capability of
therapeutic intervention.
4. 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
imaging procedures
Primary tumor search with
metastasizing malignancy.
Simbionix computer simulator
A Universal cord and plug
B Instrument control head,
C Insertion tube
5. COLONOSCOPY- Contra Indications
Perforated intestine
Acute diverticulitis
Deep ulcerations
Severe ischemic necroses
Fulminant colitis
Cardiopulmonary
decompensation
Complications and Risks
Contra Indications
Risk of perforation
Injury to blood vessels causing
bleeding
Infection
Comparing diagnostic and therapeutic
colonoscopy, more complications arise
from therapeutic measures, such as
polypectomies
6. COLONOSCOPY- Preparation
Emptying the contents of the
colon is a key requirement for a
successful colonoscopy. If the
bowel prep isn't up to par,
polyps and lesions can be
missed
A few days before the
colonoscopy procedure- Start
eating a low-fiber diet
The day before the colonoscopy
procedure - Don't eat solid
foods and have clear liquids.
The day of the colonoscopy procedure —As
on the previous day, clear liquid foods only
Don't eat or drink anything two hours
before the procedure
Now you can give either PEG- Poly
Ethylene Glycol or Sodium Picosulphate-
Fleet enema
Dissolve one pocket of anyone of this in two
Litres of fluid and ask patient to consume
Patient will purge several times within few
hours so that the bowel will get cleaned.
Can be done under IV sedation of
midazolam/fentanyl or propofol
9. 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.
10. COLONOSCOPY
Triangular configuration
and evenly spaced
haustration.
Splenic flexure with
luminal impression,
shimmering of spleen.
Relatively straight
path, oval lumen, and
evenly spaced
haustrations.
Roomy lumen
Valves of Houston
Typical submucosal
vascular pattern
Lumen cannot be seen at
about the 7-o’clock
position but can
presumed, in part due to
shadowing
Ascending colon toward
the 7-o’clock position.
The ileocecal valve, seen as
a yellowish,thickened
fold, is on the lower edge of
the lumen
Base of the cecum
Appendix orifice in the
center
Terminal ileum: velvety
mucosal surface and lacking
haustrations
