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At least 1,477 records · Page 82Linked to original sources
PubMed2003

Bowel preparation for colonoscopy in very old patients: a randomized prospective trial comparing oral sodium phosphate and polyethylene glycol electrolyte lavage solution.

BACKGROUND: Colonoscopic preparations are defectively tolerated among many very old patients and the quality of preparation is often inadequate. METHODS: Seventy-two patients aged 80 years or more were randomized to receive either NaP (37) or PEG (35) preparation. Patients' and endoscopists' opinions of the preparation and colonoscopy were ascertained, the adverse effects were recorded, clinical indicators of dehydration such as tongue dryness, upper body muscle weakness and confusion were assessed and laboratory tests were taken before and after the preparation. RESULTS: Patients' evaluations showed no significant difference regarding the tolerance of preparations. Only the frequency of nausea was higher in the NaP group (16%/9%, P = 0.01). Assessment of the indicators of dehydration showed a difference only in tongue dryness in the NaP group (P = 0.02). The quality of preparation was evaluated by endoscopists as good or excellent in 81% of cases in the NaP group and in 77% of cases in the PEG group. The median values of potassium decreased from 4.0 mmol/L to 3.7 mmol/L (P < 0.05) and of sodium increased from 142 mmol/L to 145 mmol/L (P < 0.05) after NaP preparation. CONCLUSION: Sodium phosphate and PEG preparations are almost equally tolerated and effective in very old inpatients. NaP preparations cause more changes in the levels of potassium and sodium. For those elderly patients who are vulnerable to complications caused by electrolyte disturbances we recommend PEG preparation.

Administration, Oral↗
PubMed1992

Office-based colonoscopy in a family practice.

A total of 112 patients, 64 women and 48 men, underwent 157 in-office colonoscopies with intravenous sedation. A total of 113 polyps were found. Thirty polyps were of the diminutive (less than 0.6 cm) hyperplastic (metaplastic) or nonneoplastic type. Forty-three were of the diminutive adenomatous, or villous, neoplastic type, and 40 were neoplastic but larger than 0.6 cm. Biopsies and polypectomies were done. There were no instances of perforation, hemorrhage, or other major complications. A spectrum of other colorectal pathology was found, the majority of which was treated in the office. Patients were risk stratified for surveillance according to polyp histopathology, with nonneoplastic polyps assigned no risk, and neoplastic polyps assigned high risk status. This study demonstrates that for the most reliable prognostication and risk stratification, all polyps should be removed for histopathological assessment.

Adult↗
PubMed1992

Yield of upper endoscopy in the evaluation of asymptomatic patients with Hemoccult-positive stool after a negative colonoscopy.

The yield of upper endoscopy in asymptomatic patients with positive fecal occult blood test (FOBT) and a negative colonoscopy was evaluated prospectively in 70 consecutive patients. Significant pathology was diagnosed in 19 patients (27%), eight patients with ulcers, five with arteriovenous malformations, three with esophageal or gastric varices, two with multiple erosions, and two with biopsy-proven Barrett's esophagus. Thirteen patients had iron deficiency anemia and demonstrated a 38% prevalence of significant pathology. Fifteen patients on nonsteroidal anti-inflammatory agents had a 30% prevalence of significant pathology. No statistically significant difference was noted between subgroups. In conclusion, asymptomatic patients without a colonic source to explain a positive FOBT often have significant lesions, on upper endoscopy. Iron deficiency anemia did not have an impact on pathology. Because treatment and follow-up plans were altered in many of the cases in which significant pathology was demonstrated, we conclude that upper endoscopy should be seriously considered for all asymptomatic patients with occult gastrointestinal bleeding and a negative colonoscopic examination.

Adult↗
PubMedDate not supplied

Splenic trauma following colonoscopy.

A case of splenic trauma after colonoscopy is reported. After description of their experience, the Authors report a review of the literature and some considerations about clinical diagnosis and surgical or medical therapy for this pathology.

Aged↗
PubMed1992

Detection and prevention of colon cancer by colonoscopy.

It is widely accepted that most carcinomas of the colon and rectum develop through the adenoma-to-carcinoma sequence. A recent review characterizes the various relationships between colorectal polyps and carcinoma. Tierney and Associates list several studies that show the frequent coexistence of adenomatous polyps with carcinoma of the colon or rectum. The incidence of polyps in patients with carcinoma of the colon and rectum ranges from 12.9% to 62%. Retrospective reports show a lower incidence of polyps in patients with carcinoma of the colon or rectum (13.7% to 23%). However, colon segments resected for carcinoma of the colon have a significant incidence of associated adenomatous polyps (15% to 28%). In patients with carcinoma of the colon or rectum undergoing preoperative fiberoptic colonoscopy there is a percentage of polyps larger than 5mm in diameter ranging between 36% and 62%. There is also a higher rate of both synchronous and metachronous carcinomas in patients in whom polyps coexist with the primary malignant lesion. The rate of metachronous carcinomas in patients with associated polyps at the time the first tumor was discovered is reported to be twice as great as for patients who did not have polyps (2.6% versus 1.14%, respectively). Synchronous malignant lesions were detected in 11% of patients with polyps but in only 0.7% of patients without polyps. In patients with multiple polyps coexistent with the original carcinoma, synchronous malignant lesions are found in 14.6% of patients and metachronous malignant lesions developed in 12.4%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed2005

[Diagnostic principles of colonoscopy in ulcerative colitis].

Colonoscopy plays a most important role in the diagnosis and management of ulcerative colitis (UC). It is generally performed in UC for defining the degree of disease activity, grading endoscopic disease severity, and surveillance to detect early cancer and/or dysplasia. Colonoscopic findings of UC are characterized by diffuse and continuous inflammation of mucosa. Loss of vascular pattern, erythema, petechiae and mucosal friability are features of relatively mild disease. As the severity of inflammation increases, spontaneous bleeding, erosions and/or ulcerations are observed. Although UC can be easily diagnosed by these typical findings, colonoscopic findings are modified in a variable and complicated manner at the different clinical stages. Thus it is important for endoscopists to understand the findings in each clinical stage of UC.

Colitis, Ulcerative↗
PubMed2005

Colonoscopy preparations.

Polyethylene glycol solutions versus sodium phosphate in preparing the bowel for colonoscopy.

Colonoscopy↗
PubMed2006

"Flying through" and "flying around" a PET/CT scan: Pilot study and development of 3D integrated 18F-FDG PET/CT for virtual bronchoscopy and colonoscopy.

UNLABELLED: The objective of this pilot project was to devise a new image acquisition and processing technique to produce PET/CT images rendered in 3-dimensional (3D) volume that can then be reviewed in several 3D formats such as virtual bronchoscopy and colonoscopy "fly-throughs" and external "fly-arounds." METHODS: We tested the new imaging and processing protocol on 24 patients with various malignancies to determine whether it could dependably acquire and reformat standard tomographic 2-dimensional PET/CT images into 3D renderings. RESULTS: This new technique added helpful information to the diagnostic interpretation for 2 of the 24 patients. Further, in the 6 patients undergoing mediastinoscopy, bronchoscopy, or endoscopy, 3D imaging helped in preprocedural planning. CONCLUSION: In this initial study, we demonstrated both the feasibility of rendering PET/CT images into 3D volumes and the potential clinical utility of this technique for diagnostic lesion characterization and preprocedural planning.

Adult↗
PubMedDate not supplied

Comparison of multidetector computed tomographic colonography and conventional colonoscopy for detection of colorectal polyps and cancer.

BACKGROUND: Computed tomographic colonography (CTC) is a new technique for detecting colonic neoplasms. Data on the utility of this method in the Indian population are limited. METHODS: Forty-two patients with symptoms of colonic disease underwent CTC and conventional colonoscopy (CC) within one week of each other and the findings at these two investigations were compared. RESULTS: The entire colon could be evaluated in 38 patients on CTC and in 23 patients on CC. Of the 19 patients who had incomplete CC, 14 had occlusive colonic lesions. Of the 86 lesions detected on CC, 76 (88.4%) were correctly identified on CTC with regard to location and size. CTC was false negative for 10 lesions and false positive for 5 lesions in 3 patients. The sensitivity and specificity of CTC were 65% and 77%, respectively, for lesions 1-5 mm; 97% and 83% for 6-9 mm-sized lesions; and 100% and 100% for lesions 10 mm or larger. Extracolonic findings were seen in 24 of 42 patients (57%). CONCLUSIONS: CTC is reliable for detecting lesions 6 mm or larger in size. It permits evaluation of the region proximal to an occlusive growth, which is often not possible with CC.

Adolescent↗
PubMed2006

Chromoendoscopy and its alternatives for colonoscopy: useful in the United States?

American endoscopists have essentially ignored chromoendoscopy (dye spraying) in the colon and overwhelmingly perform white-light colonoscopy only. The published studies suggest that routine use of chromoendoscopy in Western populations will lead to identification of additional flat lesions. However, a number of these studies have design flaws. The authors' interpretation of the existing data is that pancolonic chromoendoscopy to detect flat and depressed lesions is not yet proven as a useful and therefore necessary adjunct to routine colonoscopic examination in non-inflammatory bowel disease patients in the United States. Chromoendoscopy, particularly combined with magnification, is very effective in delineating the pit pattern of polyps and in allowing real-time differentiation of adenomatous from non-adenomatous lesions. There might be a role for chromo endoscopy with high magnification in the delineation of unresected portions of lateral spreading tumors being removed by piecemeal polypectomy and in the evaluation of polypectomy scars during endoscopic follow-up. The authors suggest that US endoscopists begin to familiarize themselves with shape classification, and that they learn a method to determine histology in real time.

Colonic Diseases↗
PubMed1992

Management of perforation of the colon at colonoscopy.

We propose guidelines for the management of perforation of the colon at colonoscopy based upon a comprehensive literature review. Conservative management is advocated for silent perforations and in patients with mild or localized symptoms and signs diagnosed within 4-8 h of injury. Perforations diagnosed late may be managed by nonoperative methods, if the infection is confined as determined clinically or by imaging techniques. A suspected large perforation, generalized peritonitis, or failure to improve on conservative management will mandate surgical exploration. In an intermediate group of patients, decisions regarding management will depend on crucial information regarding the circumstances surrounding the procedure. These include the endoscopist's assessment of the size, mechanism, and timing of the perforation, the adequacy of bowel preparation, delay time to diagnosis, overall condition of the patient, and the presence or absence of associated colonic pathology. Antibiotic therapy should be given to all patients immediately upon diagnosis. Single-agent therapy with cefoxitin can be used in the immunocompetent patient. Under other circumstances, combination antibiotic treatment is indicated.

Colon↗
PubMedDate not supplied

[Colonoscopy: experience in a general hospital].

The authors emphasize the colonoscopy's importance and report their experience with the procedure in a general hospital. In a nearly 4 year period, 300 patients were submitted to the procedure, and the main indication was digestive bleeding, followed by alterations of bowels movements. The bowel preparation was done with mannitol ingestion except when contraindicated. The most frequent pathology were polyps and diverticular disease. Fifty three polypectomies were done in 22 patients.

Adolescent↗
PubMed1991

Pre-colonoscopy bowel preparation intolerance: a sign of upper gastrointestinal pathology.

Severe vomiting and abdominal pain were precipitated by polyethylene glycol-based gut lavage (PEG) in two patients out of 585 referred for colonoscopy in a 2 year period. Both patients had primary adenocarcinoma of the large bowel but both were also found to have gastroduodenal problems severe enough to need surgical treatment. Both cases are presented.

Adenocarcinoma↗
PubMed1991

Colonoscopy during an attack of severe ulcerative colitis is a safe procedure and of great value in clinical decision making.

Thirty-four patients who had severe ulcerative colitis had a colonoscopic examination during the attack. The indications were resistance to therapy and/or differential diagnostic purposes. Total colonoscopy was performed in 25 cases and less extensive examination in nine. Biopsy was taken in 22 cases. No clinically significant complications occurred. The procedure helped us to postpone immediate surgical intervention in 19 cases. Fourteen of these patients have maintenance treatment and are still well after a follow-up median time of 5 yr (6 months to 10 yr).

Acute Disease↗
PubMedDate not supplied

[Colonoscopy and polypectomy].

A review of colonoscopy and polypectomy is done, since its origins. A brief description of techniques and medication is presented, as well as indications, limitations and contraindications.

Colonic Polyps↗