Colonoscopy
(Gastrointest Endosc 2003;57:441-5)
INDICATIONS:
Diagnostic:
Screening for colon polyps/cancer; including preoperative evaluation of patients with known colon cancer
Symptom evaluation: bleeding (occult or gross) or Abnormal X-ray findings (i.e. barium enema)
Screening/Surveillance for neoplasia: IBD patients, familial polyposis
Therapeutic:
Polypectomy, hemostasis of bleeding lesions, foreign body removal, decompression (Volvulus or Ogilvie’s syndrome)
COMPLICATIONS/RISK:
No absolute contraindications, considerations include:
Risk > Benefit; Risks are related to severity of underlying disease, comorbid disease, emergency/therapeutic procedures, elderly
Suspect perforation, acute diverticulitis, fulminant colitis, recent MI (risk may be greater than benefit)
Uncooperative
Irreversible coagulopathy, poor bowel preparation
Lack of informed consent
Prep related complications (depends upon type of preparation used-see below)
PEG solutions:
5-15% intolerance
Sodium phosphate or Magnesium citrate:
Fluid or electrolyte shifts
Increase in phosphate or magnesium, especially with chronic renal failure
Phosphate nephropathy
Mucosal changes: aphthoid like ulcers that can mimic IBDRelated posts:
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