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At least 721 records · Page 40Linked to original sources
PubMed2003

Pneumoretroperitoneum, pneumomediastinum, pneumopericardium, and subcutaneous emphysema complicating sigmoidoscopy: report of a case.

An 80-year-old woman presented to our outpatient center with abdominal pain and blood-stained stools. She underwent a colonoscopy, which showed a 4-cm type II tumor in the rectum. About 2 h after the colonoscopy, mild facial edema and subcutaneous emphysema developed around her neck. A chest X-ray showed pneumopericardium, pneumomediastinum, and subcutaneous emphysema, and an abdominal X-ray demonstrated retroperitoneal air. An exploratory laparotomy was performed on the second day after the colonoscopy, which showed air in the subserosal space of the sigmoid colon. The air seemed to have leaked from a 2-cm inflamed diverticulum in the sigmoid colon. The mesosigmoid was also expanded by air. We discuss the anatomical mechanism of the various clinical presentations of extraluminal air following colonoscopy.

Adenocarcinoma↗
PubMed1985

Short (35-cm) versus long (60-cm) flexible sigmoidoscopy: a comparison of findings and tolerance in asymptomatic patients screened for colorectal neoplasia.

The purpose of this study was to compare the utility of the 35-cm versus the 60-cm flexible sigmoidoscope in screening asymptomatic patients for colorectal neoplasia. Two hundred fifty-eight patients 45 years of age or older were examined in a randomized fashion with both the 35-cm and 60-cm instruments. Fifteen percent (39/258) of patients had a total of 50 polypoid lesions 3 mm or greater in diameter (including one carcinoma). Of all polypoid lesions, 76% were detected with the 35-cm instrument compared to 98% with the 60-cm sigmoidoscope. Eighty-four percent of all polyps occurred within the distal 35 cm of colon. The mean time required to complete the examination was significantly less with the 35-cm sigmoidoscope than with the 60-cm sigmoidoscope (2.5 vs. 5.7 min). Moderate to severe discomfort was experienced by 69% of patients with the 60-cm instrument compared to only 29% with the 35-cm sigmoidoscope. Seventy-two percent of patients preferred examination with the shorter instrument compared with 7% for the longer sigmoidoscope, while 21% of patients expressed no preference. The 35-cm flexible sigmoidoscope fulfills many criteria of an effective screening test for colorectal neoplasia including rapidity of examination, safety, good sensitivity, and excellent patient acceptance.

Aged↗
PubMed1982

Detection of rectal and rectosigmoid lesions by double-contrast barium enema examination and sigmoidoscopy. Accuracy of technique and efficacy of standard overhead views.

The double-contrast barium-enema examination (DC-BE) and endoscopy were compared in 100 patients (126 lesions) to determine the accuracy of each method and assess the efficacy of standard overhead views in detecting rectal and rectosigmoid masses. Seven lesions were missed with DB-BE (accurate rate, 95%) and 20 with endoscopy (accuracy rate, 84%). Lateral and angled rectum views were positive in 74% and 94%, respectively; combining these with supine, prone, and left posterior oblique views, 95% of 121 lesions were detected on at least 2 radiographs. Fifteen of 41 lesions (37%) were missed with the rigid sigmoidoscope, but only 5 of 85 (6%) with the flexible sigmoidoscope. The authors conclude that suspected rectal or rectosigmoid tumors can be diagnosed accurately with only 5 projections, rather than the 11 often employed for the entire colon, and that the flexible sigmoidoscope should be used routinely instead of the rigid sigmoidoscope.

Aged↗