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At least 577 records · Page 32Linked to original sources
PubMed1998

Colonoscopic evaluation of severe hematochezia in an Oriental population.

BACKGROUND AND STUDY AIMS: Hematochezia is a common clinical problem. When the bleeding is brisk and continuous it requires prompt hospital admission and careful diagnostic evaluation and management. Colonoscopy has become the first-line investigative modality in patients presenting with severe hematochezia in many centers, including ours. A retrospective review was carried out to evaluate the effectiveness of colonoscopy in determining the cause of severe hematochezia in our Oriental population. PATIENTS AND METHODS: One hundred and ninety patients with severe hematochezia underwent colonoscopy at the National University Hospital, Singapore, from 1 January 1988 to 31 December 1994. Their records were retrieved and the data analyzed for sex, age, presentation, concomitant medical conditions, prevalence of recent non-steroidal anti-inflammatory drugs ingestion, past history of hematochezia, investigations, subsequent interventions and outcome. RESULTS: Colonoscopy as the fist-line investigative modality identified the site and cause of hematochezia in 78% (148/190) of cases. The site of bleeding remained "obscure" even after additional investigations in 15% (29/190) of cases. The commonest cause of severe hematochezia in our Oriental population was diverticular disease (30%, 57/190) with right-sided diverticular bleeding constituting 44% (25/57) of these cases. Overall, bleeding stopped spontaneously in 81% (154/190) of cases. Surgery was performed in 16% (30/190) of cases. The mortality related to severe hematochezia in this series was 5% (9/190). CONCLUSIONS: The diagnostic efficiency of colonoscopy in defining the site and cause of severe hematochezia in the Oriental population is comparable to most Western series. The commonest cause of severe hematochezia in our population was diverticular disease.

Adolescent↗
PubMed1982

Colonoscopic appearance of the remnant of the appendix after total inversion.

In a series of 395 total colonoscopies, an oblong smooth tumor was seen in the cecum of six patients corresponding to the remnant of the totally inverted appendix. All the patients had undergone a laparotomy during which the appendix was inverted. The histological examination demonstrated a uniform finding without any signs of polyp or malignancy. Our findings stress that the appendix fails to undergo necrosis after total inversion in some cases, in which the changes in the cecum can be readily identified by total colonoscopy.

Adult↗
PubMed1982

Surveillance intervals after colonoscopic polypectomy.

Two hundred and twenty seven patients had multiple follow-up total colonoscopies after initial endoscopic polypectomy. All adenomas were removed at the initial examination ('clean colon') in those patients who had no history of colon cancer, inflammatory bowel disease or polyposis coli; when re-endoscoped within one year 56% of them were found to have further adenomas. Nine percent had adenomas over 10 mm diameter which are presumed to have been missed during the index colonoscopy. Patients with single or multiple adenomas had an equal likelihood of being found to have further lesions on a one-year follow-up colonoscopy. With an apparent chance of missing a significant-size polyp at colonoscopy of at least 10% we recommend that all patients have a follow-up colonoscopy within one year after polypectomy. 133 Patients in whom no adenomas were found at the one year colonoscopy ('negative colonoscopy') were followed up. The incidence of new adenomas occurring within four years of 'negative colonoscopy' was 35% for those with a single adenoma at the index examination and twice as high for patients with multiple adenomas. If no polyp is found at one year, we recommend that interval follow-up colonoscopies should be performed every two years if more than one adenoma was removed during the initial examination, and every three years if only one was removed.

Adenoma↗
PubMed1980

Clinical application of an improved magnifying fiber-colonoscope (FCS-ML II), with special reference to the remission features of ulcerative colitis.

We have adapted a new, high-performance magnifying fibercolonoscope (FCS-ML II) developed by Machida Industries, for clinical use. We have observed the remission process of ulcerative colitis with this new instrument and have compared our findings with those obtained by clinical examination, X-ray, ordinary gastroscope, and histologic examination of biopsy specimens. Our results show that the findings of magnifying fiber-colonoscopy correspond to those obtained with biopsy and histology, indicating that this new instrument promises to be a highly effective tool for the accurate assessment of the degree of remission of ulcerative colitis.

Colitis, Ulcerative↗
PubMed2005

Colonoscopic screening of average-risk women for colorectal neoplasia.

BACKGROUND: Veterans Affairs (VA) Cooperative Study 380 showed that some advanced colorectal neoplasias (i.e., adenomas at least 1 cm in diameter, villous adenomas, adenomas with high-grade dysplasia, or cancer) in men would be missed with the use of flexible sigmoidoscopy but detected by colonoscopy. In a tandem study, we examined the yield of screening colonoscopy in women. METHODS: To determine the prevalence and location of advanced neoplasia, we offered colonoscopy to consecutive asymptomatic women referred for colon-cancer screening. The diagnostic yield of flexible sigmoidoscopy was calculated by estimating the proportion of patients with advanced neoplasia whose lesions would have been identified if they had undergone flexible sigmoidoscopy alone. Lesions were considered detectable by flexible sigmoidoscopy if they were in the distal colon or if they were in the proximal colon in patients who had concurrent small adenomas in the distal colon, a finding that would have led to colonoscopy. The results were compared with the results from VA Cooperative Study 380 for age-matched men and women with negative fecal occult-blood tests and no family history of colon cancer. RESULTS: Colonoscopy was complete in 1463 women, 230 of whom (15.7 percent) had a family history of colon cancer. Colonoscopy revealed advanced neoplasia in 72 women (4.9 percent). If flexible sigmoidoscopy alone had been performed, advanced neoplasia would have been detected in 1.7 percent of these women (25 of 1463) and missed in 3.2 percent (47 of 1463). Only 35.2 percent of women with advanced neoplasia would have had their lesions identified if they had undergone flexible sigmoidoscopy alone, as compared with 66.3 percent of matched men from VA Cooperative Study 380 (P<0.001). CONCLUSIONS: Colonoscopy may be the preferred method of screening for colorectal cancer in women.

Adenoma↗
PubMed2000

A novel tableted purgative for colonoscopic preparation: efficacy and safety comparisons with Colyte and Fleet Phospho-Soda.

BACKGROUND: Currently available aqueous purgatives used before colonoscopy are poorly tolerated. We designed a tableted sodium phosphate purge that we believe will yield much greater patient acceptance. METHODS: A total of 305 outpatients undergoing routine diagnostic colonoscopy were randomized to one of three preparation groups: Colyte (100 patients), Fleet Phospho-Soda (106 patients), or sodium phosphate tablets (99 patients). Endoscopists were blinded to the type of preparation administered and answered a questionnaire regarding preparation quality. Patients answered a questionnaire designed to analyze tolerability. Adverse events were closely followed and recorded. RESULTS: There were no significant differences in quality of preparation across the groups (80% excellent or good, 4% repreparation). Although hypocalcemia (4 of 71), hypokalemia (18 of 68), and hyperphosphatemia (39 of 69) were observed in patients receiving the tablets, no adverse events occurred. Patients preferred taking the tablets over Colyte and Fleet Phospho-Soda. CONCLUSION: The evaluation of a novel delivery system of a sodium phosphate purge is described. Intended for use before colonoscopy, it circumvents the poor taste and excessive volume of ingestion that are aversive to patients. The tableted purgative is equally effective, safe, and greatly preferred over the existing aqueous preparations. This may improve patient compliance with recommendations for screening colonoscopy.

Administration, Oral↗