Atrial fibrillation during flexible sigmoidoscopy.
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Immediate open surgery has been recommended for the management of perforation during colonoscopic examination. Laparoscopic closure for perforation of the sigmoid colon caused by diagnostic colonoscopy is described. The perforation site was identified in the antimesenteric border of the sigmoid colon by laparoscopic survey, and four ports were inserted in the lower abdomen. The margin of the perforation was lifted by two graspers, and the defect was completely closed using an endoscopic linear stapler. The patient recovered quickly without any associated complications. Postoperative barium enema showed no stenosis or leakage. This method is less invasive and allows earlier recovery of patients with colonic perforation.
Anatomic localization of the tip of a colonoscope without the aid of fluoroscopy is adequate in a majority of patients. External check points of transilluminated light within the colon on the abdominal wall, characteristic internal appearance of the colon and gross anatomic landmarks have been used. An improved technique for advancement results if a routine sequence of maneuvers is used in a similar manner in all patients.
An apparatus is constructed for the determination of the rectosigmoid transition tonus-rectosigmoid tonometer. There pressure will be read in Torr. The investigation of the rectosigmoid tonus of 75 healthy subjects established that it ranges between 15-30 Torr. Pathologically changed RST was established in 37-elevated in 12 patients and reduced in 21 and zero in 4-during the tonus determination of 100 patients with different forms of chronic colitis. The results from the rectosigmoid tonometry must be interpreted together with the rest of the indices (AT, size of rectal folds, etc).
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