Therapeutic colonoscopy (2)

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mostafa hegazy

HEGAZY SURGERY

Health & Medicine

Lower Acute GIT bleeding
 PR must precede colonoscopy
 Preparation
 Small intestine (10%, blind)
 Colon (Angiodysplasia, Diverticulosis)
 Angiography
 CT angiography
 Others
 No barium

Obstruction
 Limitations and complications
 Stenting tumours up to sigmoid
 Untwisting volvulus

Polyps
 Snaring
 Preservation of rectum in total colectomy

Infammatory bowel disease
 Follow-up (complications)
 Deompression in acute dilatation

Tumours
 Distance from anal verge
 Associated polyps (Extent of resection /
polypectopy)
 Synchronous tumours
 Anastomotic recurrence / stricturing
 Tumour / Anastomotic bleeding
 Before reversal of Hartmann’s procedure
 Differentiation from other diseases

Fistula
 Recto vaginal fistula: Mass, from which?
 Biopsies
 Not very useful for colovesical

 Foreign body extraction
 Ablation of angiodysplasia
 Pre-operative marking
 NOTES

Do not do colonoscopy
 Colonic perforation / leakage
 Secondary peritonitis
 Most cases of obstruction

Do colonoscopy without colonic
symptoms
 Familial polyposis
 Inguinal hernia for first time in the elderly
 Iron deficiency anemia with no apparent
cause
 Hepatic focal lesion indefinitely hepatoma

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