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At least 703 records · Page 39Linked to original sources
PubMed1976

A comparison of hysterosalpingography and endoscopy in evaluation of tubal function in infertile women.

A comparison of hysterosalpingography (HSG) with endoscopy in the evaluation of tubal function in 117 infertile women is presented. Results were in accord in 55% of the patients. Correction for endoscopic error and the limitations of HSG increased the positive correlation to 74%. Twenty-three patients (20%) with abnormal findings at HSG were normal with endoscopy. Ten patients (8%) had normal HSG but abnormal endoscopic findings. Fifteen patients (12%) with positive findings by HSG had different positive findings at endoscopy. Additional endoscopic findings in 47 patients are listed. Review of 26 patients with endoscopy-confirmed endometriosis revealed that 14 (54%) had a normal HSG and normal history and pelvic examination. Although HSG should be the method of choice as part of the basic evaluation, an infertile woman should undergo endoscopy before the evaluation is considered complete or final.

Culdoscopy↗
PubMed1987

A comparison of direct and indirect video endoscopy.

The advent of microchip video cameras has opened another technology to endoscopy of the gastrointestinal tract: video endoscopy. With direct video endoscopy, the microchip camera is mounted on the distal tip of the endoscope; with indirect video endoscopy, a miniature camera is coupled to the eyepiece of a standard fiberoptic endoscope. Both systems view the procedure on a monitor. The systems were "bench" tested in an electronics laboratory to objectively compare resolution, brightness (luminosity), and color intensity (chroma). Clinical comparison was performed in 619 patients. Both video endoscopy systems provided significant advantages over fiberoptic endoscopes in therapeutic procedures, teaching, and documentation. The direct video system provided the best overall video image; the indirect system had a slightly diminished resolution and luminosity in both the "bench" test and clinical evaluation.

Digestive System↗
PubMedDate not supplied

Upper gastrointestinal endoscopy without sedation: a prospective study of 2000 examinations.

Various drugs are used for sedation prior to upper gastrointestinal endoscopy, some with undesirable side effects. In an attempt to avoid these side effects, 2000 upper diagnostic gastrointestinal endoscopies were performed in a period of 4 years between 1982 and 1986, without any sedation, using Olympus GIF-Q and GIF-P3 gastroscopes. Anxiety, ease of introduction of gastroscope, tolerance of the procedure, and the overall success of the procedure were assessed. Most patients were calm (81.2%); 94.4% had an easy introduction of the gastroscope, 80.3% tolerated the procedure well; and 94.2% of the endoscopies were completely successful. There were no complications, and only four examinations failed (0.2%). Sedation had to be used (intravenous diazepam) in 32 patients due to excessive anxiety and an inability to introduce the gastroscope and in three children under 10 years (1.6%). The average time needed to complete an endoscopy without sedation was found to be 9.5 min, nearly half of the average time needed before this study when sedation was routinely given. It is concluded that upper gastrointestinal endoscopy without sedation can be a safe, quick, well-tolerated procedure.

Adult↗
PubMedDate not supplied

Can bowel endoscopy predict colorectal surgery in patients with an adnexal mass?

The objective of this retrospective study was to identify the ability of preoperative endoscopy of the lower gastrointestinal tract and other tests to predict large bowel resection in patients with an adnexal mass. We reviewed 573 patients with a suspected adnexal mass admitted for surgery between 1987 and 1997. Two hundred fifty four patients (44%) had preoperative sigmoidoscopy (n = 97) or colonoscopy (n = 157). We identified patients who underwent a colorectal operation as part of their surgery and correlated surgical findings with the results of preoperative endoscopy, preexisting clinical symptoms, preoperative pelvic exam and ultrasonography, and the CA125 level. The sensitivity and positive predictive value of bowel endoscopy for predicting large bowel surgery were 18% and 59%, respectively. Multivariate analysis showed preexisting bowel-related symptoms, a pelvic exam suggestive of malignancy, a CA125 value >1000 U/ml, and infiltration of the colorectal wall at bowel endoscopy to be independently associated with subsequent colorectal surgery. We conclude that preoperative bowel endoscopy cannot accurately predict colon resection in patients with a suspected adnexal mass. Preexisting bowel-related symptoms, a pelvic exam suggestive of malignancy and a CA125 value >1000 U/ml are associated with subsequent colorectal surgery.

Adnexal Diseases↗
PubMed2001

Long-lasting reduction of risk of colorectal cancer following screening endoscopy.

Several studies have suggested that incidence and mortality of colorectal cancer (CRC) may be strongly reduced for up to 10 years by endoscopic screening with removal of precancerous lesions, but so far there are no data on risk reduction beyond this period. We assessed long-term reduction of CRC risk following screening endoscopy in a statewide population-based case-control study in Saarland, Germany. Lifetime history of screening endoscopy was compared between 320 cases with CRC aged 45-80 and 263 controls with other forms of cancer recruited from the same population. Potential confounding factors were controlled for by multiple logistic regression. 11% of cases compared to 27% of controls had a history of endoscopy for screening purposes (adjusted odds ratio (OR) = 0.28, 95% confidence interval (CI): 0.16-0.48). This strong risk reduction was also seen (OR = 0.41, 95% CI: 0.19-0.89) in subjects who had their last screening endoscopy more than 10 years ago (median: 18.9 years). Long term (> 10 years since last screening) risk reduction appeared to be particularly strong for advanced (Dukes C or D) CRC (OR = 0.19, 95% CI: 0.06-0.64). We conclude that risk reduction by screening endoscopy is long lasting, in particular with respect to advanced CRC.

Aged↗
PubMed2001

A prospective controlled trial of an ultrathin versus a conventional endoscope in unsedated upper gastrointestinal endoscopy.

BACKGROUND AND STUDY AIMS: Upper gastrointestinal endoscopy is performed without sedation in many countries. Unsedated patients experience more discomfort during endoscopy than sedated patients, but few studies have examined factors which could be modified to minimize discomfort during the procedure. We assessed the effect of endoscope diameter on patient discomfort during unsedated transoral gastroscopy. PATIENTS AND METHODS: A total of 322 patients attending for unsedated endoscopy were examined using an endoscope of diameter either 6.0 mm or 9.8 mm. Patients completed a two-part questionnaire assessing tolerance of the procedure and discomfort during it. RESULTS: There was failure to complete the initial unsedated endoscopy in three of 163 patients in the 6.0 mm group and 14 of 159 in the 9.8 mm group (P = 0.009). Patients in the 6.0 mm group reported less discomfort both during endoscope insertion (P < 0.0001) and during the remainder of the procedure (P < 0.0001). 14% of patients in the 6.0 mm group indicated that they would request sedation if a further endoscopy were necessary, compared with 31% in the 9.8 mm group (P = 0.0005). CONCLUSIONS: Ultrathin endoscopes may have a role in clinical practice if randomized comparative studies with standard-bore instruments confirm that they do not compromise diagnostic quality.

Adolescent↗
PubMed1986

[First clinical experience with coronary endoscopy].

In four different groups coronary endoscopy and endoscopy of peripheral vessels was carried out, using two ultrathin fibre endoscopes with a working length of 120 cm and a diameter of 1.4 or 1.8 mm. In a first series of seven cadaver hearts, normal vessels were found in three, one had high-grade stenosis and in the remaining three there were flat whitish atheromatous changes, rather scar-like in appearance. In a second series of 16 patients, the vascular wall in the iliac region was easily visualised in ten, while six showed diffuse atherosclerotic changes of the wall. In a third group of eight patients, coronary endoscopy was carried out at the time of balloon-catheter dilatation; endoscopy was successful in five patients. In two of them, the stenosis or occlusion to be dilated by balloon was visualised. In a fourth series, good visualisation of the vessels was obtained intraoperatively in seven out of nine patients, and in addition the course of the vessel distal to the stenosis as well as the site of anastomosis with the venous bypass graft could be seen. No serious side-effects of the procedure have yet been observed. Coronary endoscopy opens up a new dimension in the morphological assessment of coronary vascular changes. The method must, however, still be regarded as experimental.

Angioplasty, Balloon↗
PubMed2004

Value of digital high-speed endoscopy in addition to videofluoroscopic imaging of the neoglottis in tracheoesophageal speech.

OBJECTIVE: To gain insight into the clinical value of using the relatively new evaluation tool digital high-speed endoscopy in addition to the widely used method of videofluoroscopy for imaging of the neoglottis in tracheoesophageal speech after total laryngectomy. MATERIAL AND METHODS: Anatomical and morphologic characteristics of the neoglottis in 37 laryngectomized patients using tracheoesophageal speech were studied by means of visual assessment of digital high-speed endoscopy recordings and visual assessment and quantitative measures of videofluoroscopy recordings, using previously published protocols. RESULTS: Digital high-speed endoscopy provides information complementary to that of videofluoroscopy with respect to the location of the vibration, presence of a mucosal wave, regularity of the vibration and closure of the neoglottis The information provided by digital high-speed endoscopy overlaps with that provided by videofluoroscopy with respect to the amount of saliva (regurgitation of barium in videofluoroscopy) and the visibility of the origin of the neoglottis (presence of a neoglottic bar in videofluoroscopy). Additionally, relationships were found between the visual assessments of the high-speed recordings and some patient characteristics. CONCLUSIONS: Digital high-speed endoscopy provides additional insight into neoglottic characteristics that cannot be studied with videofluoroscopy. The application of both imaging methods enhances the insight into tracheoesophageal voicing.

Aged↗
PubMed1996

Paediatric upper gastro-intestinal endoscopy in developing countries.

A retrospective study of 200 endoscopies performed on 168 children (90 girls and 78 boys) aged 3 months to 18 years (median 6 years) is reported. All procedures were completed successfully in an adult endoscopy unit in a comprehensive health centre. Most children of less than 6 months and above 12 years of age needed no intravenous sedation. One child developed respiratory depression and was successfully resuscitated. Indications for endoscopy were: small intestinal biopsy, 78 (46%); recurrent abdominal pain, 40 (24%); acute epigastric pain, 13 (8%); persistent vomiting, 12 (7%); haemorrhage, 10 (6%); caustic substance ingestion, six (4%); and dysphagia, four (2%) children. Positive diagnoses were obtained in 123 (62%) procedures. Coeliac disease (26 cases) was the most common histological diagnosis, followed by gastritis (19 cases), oesophagitis (18 cases), duodenitis (16 cases), duodenal ulcer (11 cases), hiatus hernia (six cases), gastric ulcer (three cases) and oesophageal stricture (two cases). Where specialized paediatric endoscopy units are not feasible, e.g. in developing countries, endoscopic services for children can be safely provided by paediatric endoscopists as part of an adult endoscopy service, provided that suitable resuscitation equipment is available and the necessary modifications to meet the medical and psychological needs of children and their parents are taken into consideration.

Adolescent↗
PubMed1990

Development and application of a falloposcope for transvaginal endoscopy of the fallopian tube.

A small flexible microendoscope with an outside diameter (OD) of 0.5 mm has been developed for effective visualization of the entire length of the human fallopian tube. Using a transvaginal approach, a small flexible operating hysteroscope with an OD ranging from 3.3 to 4.5 mm, was used to visualize the uterotubal ostium (UTO) for cannulation of the tube. A coaxial technique, incorporating guidewire cannulation, placement of an "over the wire" Teflon catheter, and replacement of the guidewire with a falloposcope, for video documentation of endotubal surface anatomy has been carried out without complication in 55 women who had a total of 84 tubes available for tubal endoscopy. Characterization of normal and abnormal epithelial changes has been documented for the intramural, isthmic, ampullary, and fimbrial tube. Technical difficulties related to failure to negotiate the entire tubal lumen in the absence of obstructive disease occurred in 9 (11%) of the 84 endoscopy cases. These technical difficulties have been partly overcome by the incorporation of smaller directional guidewires, softer distortion-free Teflon catheters, improved microendoscopes, and the acquisition of new surgical skills necessary for safe and successful endoscopy of the fallopian tube. Minor difficulties were experienced in 7 (8%) of 84 endoscopies due to ostial spasm secondary to attempted guidewire cannulation. Cannulation was successful once spasm ceased. Of the 75 (89%) remaining successful tubal endoscopies, documentation of endotubal lesions ranging from accumulated debris, nonobstructive intraluminal adhesions, stenosis, polyps, to total fibrotic obstruction were observed in 43 (57%) examinations. The majority (70%) of these lesions were confined to the medial third of the tube, between the UTO and ampullary isthmic junction (AIJ). The tubal lumen was considered to be endoscopically normal in 32 (42%) examinations. Techniques of tubal aquadissection (TA), guidewire cannulation (GC), wire guide dilitation, and direct balloon tubuloplasty (DBT) under hysteroscopic-falloposcopic-laparoscopic control were devised for attempting to break down intraluminal adhesions, dilate a stenosis, or open up an obstruction in 35 of the 43 tubes containing a lesion. Combinations of these tubuloplasty techniques were effective for dislodging debris, breaking down adhesions, or dilating stenoses in 16 (58%) of 29 cases and consistently ineffective for bypassing true fibrotic obstructions in 6 (100%) of 6 cases. A detailed description of the falloposcope, its accessory instrumentation, and technique of falloposcopy is outlined. Additionally, preliminary evaluation of falloposcopically directed tuboplasty techniques and their effects on tubal lesions are described. This transvaginal endoscopic technique has been termed falloposcopy and the microendoscopic instrument, a falloposcope.

Adult↗
PubMed1980

Lack of transmission of type B hepatitis by fiberoptic upper endoscopy.

We prospectively investigated the possibility that type B hepatitis might be transmitted during fiberoptic endoscopy from hepatitis B surface antigen (HBsAg)-positive patients to others subsequently endoscoped. All 186 patients having upper gastrointestinal endoscopy during a 6-month period at the Washington, D.C., Veterans Administration Medical Center had a blood sample obtained at the time of the procedure. Three patients were found to be HBsAG-positive and 45 others to have either antibody to HBsAg (anti-HBs) or antibody to hepatitis B core antigen (anti-HBc). Follow-up evaluation for evidence of type B hepatitis and hepatitis B virus infection was possible in only 76% of patients. One patient developed type B hepatitis. This patient's endoscopy did not follow endoscopy of any known HBsAg-positive individual, but he had received five units of blood 5 months before hepatitis developed. No other patient showed clinical, biochemical, or serologic evidence of hepatitis during the follow-up period. These data suggest that transmission of type B hepatitis during fiberoptic endoscopy is rare, if it occurs at all, and support the current policy of not sterilizing the fiberoptic endoscope between procedures and of not routinely screening patients for HBsAg.

Adult↗
PubMed2002

Short course of omeprazole: a better first diagnostic approach to noncardiac chest pain than endoscopy, manometry, or 24-hour esophageal pH monitoring.

UNLABELLED: Noncardiac chest pain (NCCP) presents as a frequent diagnostic challenge, with patients tending to use a disproportionate level of health care resources. Gastroesophageal reflux disease (GERD) is the most frequent cause of NCCP. GOALS: To test the efficacy of a potent acid-suppressing agent as a diagnostic test in the evaluation of NCCP and to compare it with three commonly used tests. STUDY: Eighteen men and 24 women, aged 22 to 77 years, who presented with recurrent chest pain complaints of a noncardiac etiology, as determined by rest/stress perfusion imaging with technetium Tc99m sestamibi (MIBI), were enrolled in a prospective, double-blinded, placebo-controlled, crossover trial using high-dose omeprazole. Thirty-seven patients completed both arms of the trial. Findings were compared with those of endoscopy, manometry, and ambulatory 24-hour two-channel esophageal pH monitoring. All patients underwent initial diagnostic upper endoscopy, esophageal manometry, and 24-hour pH monitoring. Patients were then randomly assigned to either placebo or omeprazole (40 mg/d orally twice daily) for 14 days, washed out for 21 days, and then crossed over. Patient's symptoms were determined using a Visual Analogue Scale to measure the severity of chest pain before and after each period. RESULTS: Seventy-one percent of patients in the omeprazole arm reported improved chest pain, whereas only 18% in the placebo arm did. Abnormal results on manometry (20%), 24-hour pH monitoring (42%), or endoscopy with visual evidence of esophagitis (26%) were found less frequently. Combination of the three tests did not significantly increase their usefulness. In NCCP patients with GERD, as defined by positive results on a 24-hour pH test or presence of esophagitis on endoscopy, omeprazole treatment led to a response in 95% of patients, whereas 90% of GERD-positive patients treated with placebo did not respond. Of NCCP patients determined to be GERD negative, 39% responded to omeprazole. CONCLUSIONS: Omeprazole as a first diagnostic tool in the evaluation of MIBI-negative NCCP is sensitive and specific for determining the cause of NCCP. Endoscopy, manometry, and 24-hour pH monitoring were not only less sensitive in diagnosing NCCP, but they were significantly more expensive.

Adult↗
PubMed1998

A retrospective analysis of airway endoscopy in patients less than 1-month old.

OBJECTIVES: To review the authors' experience with neonates who underwent endoscopy over an 8-year period. STUDY DESIGN: Retrospective review in a tertiary care children's hospital. METHODS: Sixty-two neonates who underwent endoscopy were reviewed. RESULTS: Common indications for endoscopy were stridor (56%), apnea/cyanotic episodes (30%), and feeding difficulty (23%). Laryngeal abnormalities were the most frequent finding, including laryngomalacia (19%), glottic edema (19%), and vocal cord paralysis (13%). Pierre Robin sequence was the most common associated anomaly. Forty-eight neonates (77.4%) had more than one endoscopic finding. Gastroesophageal reflux diagnosed by barium swallow or esophageal pH monitoring was found in 34%. Gastroesophageal reflux was the only identified etiologic factor in four cases. Computed tomography and magnetic resonance imaging provided less information than endoscopy. CONCLUSIONS: Endoscopy in symptomatic neonates can determine etiology of distress most of the time. Multiple diagnoses were found in 77.4% of the neonates, emphasizing the need for a thorough aerodigestive tract examination. Concomitant diagnoses including gastroesophageal reflux, congenital heart disease, and pulmonary disease were found in 87.1% of neonates. Neonates have a higher likelihood of having multiple lesions in the aerodigestive tract as compared with older infants or children.

Apnea↗
PubMed1987

Patient preference in upper gastrointestinal studies: roentgenography versus endoscopy.

We prospectively compared roentgenography and endoscopy of the upper gastrointestinal tract in terms of patient acceptance and tolerance. Endoscopy was significantly better tolerated and easier overall for patients. Patients found no difference between endoscopy and radiography with respect to pain or life-style interruption. Patients stated that they would prefer endoscopy to roentgenography if repeat evaluation were needed. We conclude that UGI endoscopy is better tolerated and more acceptable to patients than UGI roentgenography.

Adult↗
PubMed2006

Clinical utility of wireless capsule endoscopy: experience with 200 cases.

GOALS: To evaluate the indications and diagnoses made with 200 small bowel capsule endoscopies in an academic medical center. BACKGROUND: Wireless capsule endoscopy (PillCam SB) has recently become available as a new tool in the evaluation of patients with small bowel diseases. Its impact on patient care and usefulness in clinical practice has steadily been gaining ground, yet there are few studies that evaluate large numbers of patients. METHODS: A retrospective review of wireless capsule endoscopies was performed between September 2003 and January 2005. Reviewed are the indications for the studies, number of complete and incomplete examinations, evaluation of gastric and small bowel transit times, findings made on examination, and the percent of diagnoses made and diagnoses suspected for each study indication. RESULTS: A total of 200 cases were reviewed. Indications included anemia (66% of cases), gastrointestinal hemorrhage (31% cases), abdominal pain (21% cases), diarrhea (11% cases), and other indications such as evaluation of abnormal radiographic findings or surveillance of inflammatory bowel disease (9% cases). The average patient age was 61.5 years (SD +/- 19.1 years). Males comprised 49% of patients. The wireless capsule endoscopy study completely evaluated the entire small bowel in 87% of cases. The most common cause for an incomplete examination was premature battery failure in 8% of cases. Only 9.5% of studies were normal without findings. Small bowel ulcerations were present in 38% of studies. Vascular ectasias were present in 23% of studies. Overall, a diagnosis was made in 23% of all studies, whereas a diagnosis was suspected based on the findings in an additional 31% of studies. The indication with the highest percentage of diagnoses made or suspected was gastrointestinal hemorrhage, with a diagnostic yield of 65%, followed by anemia 61%, diarrhea 36%, and pain 17%. CONCLUSIONS: Wireless capsule endoscopy is a valuable diagnostic tool in the evaluation of occult small bowel lesions, and was most effective in patients with gastrointestinal hemorrhage and anemia.

Endoscopes, Gastrointestinal↗
PubMed2004

Long-term follow-up of empirical treatment or prompt endoscopy for patients with persistent dyspeptic symptoms?

BACKGROUND: There are concerns about the safety and possible high costs of ongoing proton pump inhibitor therapy of empirical management strategies for patients with persistent dyspeptic symptoms. AIM: To compare the long-term results of two treatment strategies: empirical treatment followed by the Helicobacter pylori test and treat strategy (treat and test group) and prompt upper gastrointestinal endoscopy followed by directed medical treatment (endoscopy group). METHODS: In this study we describe the long-term follow-up data from a previously published randomized clinical trial. At least 6 years after randomization all participating general practitioners and patients were asked to give information about medication use, diagnostic testing, symptoms and quality of life by questionnaire. RESULTS: Information about a total of 77 out of the 80 patients initially included (96%) was retrieved. Overall, 16 patients from the treat and test group (41%) underwent 18 diagnostic investigations. The 34 patients (100%) from the endoscopy group underwent 38 investigations (P < 0.01). The number of patients of the treat and test group and endoscopy group using acid inhibition therapy was 15 (38%) and 19 (56%), respectively (P = 0.14). There were also no differences in symptom prevalence and quality of life between the groups. CONCLUSIONS: Treat and test management for patients with dyspeptic symptoms is safe and does not lead to additional diagnostic testing or use of medication when compared to prompt endoscopy.

Anti-Ulcer Agents↗
PubMed2004

Enhanced expression of interleukin-8 and activation of nuclear factor kappa-B in endoscopy-negative gastroesophageal reflux disease.

OBJECTIVE: Interleukin-8 (IL-8) mediates neutrophil trafficking via its receptors. Recent studies have shown that IL-8 is likely involved in the development and progression of erosive reflux esophagitis (RE), yet little is known about its implication in endoscopy-negative gastroesophageal reflux disease (GERD). The purpose of this study was to determine IL-8 messenger ribonucleic acid (mRNA) expression levels in endoscopy-negative GERD, along with assessment of nuclear factor kappaB (NF-kappaB) activation, which upregulates IL-8 expression. METHODS: We studied 31 patients with endoscopy-negative GERD, 15 patients with erosive RE, and 15 asymptomatic controls. Paired biopsy samples were taken from the esophagus 3 cm above the gastroesophageal junction; one biopsy was snap-frozen for measurement of IL-8 mRNA levels by real-time quantitative polymerase chain reaction, and another was formalin-fixed for histopathological evaluation. In nine endoscopy-negative GERD patients, the IL-8 mRNA expression levels were measured before and 8 wk after treatment with lansoprazole. We also sampled additional specimens for NF-kappaB-DNA binding assay and immunohistochemical analyses of NF-kappaB p65 and p50 subunits, IL-8 and specific IL-8 receptor, CXCR-1. RESULTS: The relative IL-8 mRNA expression levels were significantly higher in esophageal mucosa of patients with endoscopy-negative GERD than those of the controls. The presence of basal zone hyperplasia and intraepithelial neutrophils, histopathological hallmarks of GERD, were associated with higher levels of IL-8 mRNA. Lansoprazole treatment significantly reduced the IL-8 mRNA expression levels. The esophageal epithelium of patients with GERD showed intense immunoreactivity for IL-8, and expressed CXCR-1 antigen. We found NF-kappaB activation in esophageal mucosa in GERD patients and the NF-kappaB subunits were localized predominantly in the nuclei of IL-8-expressing cells. CONCLUSIONS: Our results demonstrate enhanced mucosal expression of IL-8 in incipient GERD even without mucosal breaks. NF-kappaB activation may be implicated in the pathogenesis in GERD.

Adult↗
PubMed2003

Cardiovascular effects at multi-detector row CT colonography compared with those at conventional endoscopy of the colon.

PURPOSE: To compare the cardiovascular effects of computed tomographic (CT) colonography and conventional endoscopy in a group of patients undergoing both procedures. MATERIALS AND METHODS: A total of 144 patients underwent CT colonography followed by flexible sigmoidoscopy (40 patients) or colonoscopy (104 patients). Pulse, blood pressure, and oxygen saturation were measured before, during, and after the procedures. Forty patients also underwent continuous Holter electrocardiographic (ECG) monitoring. Periprocedural pain was assessed by using a handheld counting device. Outcome variables were assessed by using a combination of paired t testing and multilevel linear regression. RESULTS: When a spasmolytic was not used, CT colonography was associated with only a small increase in oxygen saturation (P =.03), while use of a spasmolytic caused an increase in pulse (mean increase, 19.9 beats per minute; P <.001) and diastolic blood pressure (mean increase, 5 mm Hg; P <.001). Compared with that at CT, oxygen saturation decreased significantly during and after colonoscopy and sigmoidoscopy (mean decrease after colonoscopy with sedation, 1.0%; P <.001). Systolic and diastolic blood pressure also decreased during and after colonoscopy (mean systolic decrease after colonoscopy with sedation, 16.6 mm Hg, P <.001; mean diastolic decrease after colonoscopy with sedation, 7.5 mm Hg, P <.001). Patients were 30.3 times more likely to develop bradycardia after endoscopy (95% CI: 2.65, 346; P =.006). Ventricular couplets were significantly higher at endoscopy than at CT in patients with a history of cardiac disease (odds ratio: 72.5 and 95% CI: 4.56, 1,153 at CT vs odds ratio: 14.6 and 95% CI: 0.96, 222 at endoscopy; P =.002). Patients were 1.89 times more likely to register pain during colonoscopy than during CT (95% CI: 1.06, 3.38; P =.03). CONCLUSION: CT colonography had no significant cardiovascular effect other than spasmolytic-induced tachycardia. Endoscopy-and colonoscopy in particular-causes cardiovascular effects that are largely related to sedation. CT colonography is less painful than colonoscopy and is comparable to flexible sigmoidoscopy.

Adult↗