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At least 1,261 records · Page 70Linked to original sources
PubMed1997

Computed tomographic colography and virtual colonoscopy.

CT colography (CTC) is a powerful new approach to imaging the colorectum and a promising screening tool for the detection of colorectal neoplasia. From data generated by a helical CT scan, CTC uses virtual reality technology to produce highly discriminant two- and three-dimensional images that permit a thorough and minimally invasive evaluation of the entire colorectum. A dynamic CTC display technique from the endoluminal perspective, called cf2virtual colonoscopy,cf1 simulates colonoscopy by "flying" through the three-dimensional colon image. CTC offers potential advantages in diagnostic performance, safety, and patient acceptance over current screening approaches. Although early data suggest excellent colorectal polyp detection rates, this nascent technology will require rigorous clinical investigation and further refinements to assess adequately its place in the endoscopist's armamentarium.

Barium Sulfate↗
PubMed1997

Delayed presentation of splenic trauma following colonoscopy.

Splenic trauma is a rare complication of colonoscopy, and diagnosis of such an injury is often delayed and made only at laparotomy. Although computerized tomography may be helpful, a knowledge of this complication is the best tool to aid in early diagnosis. In this article, a case of splenic trauma is presented that was associated with a flexible fiberoptic colonoscopy and required an urgent splenectomy five days after the procedure.

Colonoscopy↗
PubMedDate not supplied

A randomized prospective trial comparing 45 and 90-ml oral sodium phosphate with X-Prep in the preparation of patients for colonoscopy.

Forty-six patients were randomized to receive either 45 or 90-ml oral sodium phosphate (NaP) (Fleet Phospho-Soda), or X-Prep (a Senna preparation) before elective colonoscopy to compare the quality of colon cleansing, ease of preparation, and gastrointestinal intolerance. Before colonoscopy, one of us administered a questionnaire to the patient to assess how well the preparation was tolerated (scale from 1 to 5: 1 = easy, to 5 = unable to finish) and about the presence of four symptoms:abdominal pain, nausea, vomiting, and dizziness. The quality of colon cleansing was graded by two gastroenterologists (1 = excellent, 2 = good, 3 = fair, 4 = poor), who were unaware of how the patient was prepared or tolerated the preparation. The overall quality of bowel preparation with 90-ml oral NaP was better than with X-Prep and 45-ml NaP (p < 0.01). Patients found preparation with NaP to be easier than X-Prep (p < 0.002). No difference was seen in the incidence of abdominal pain, nausea, vomiting or dizziness. In the 90-ml NaP group, a significant rise in sodium and chloride occurred. However, increments were not greater than 5%. Hyperphosphatemia was noted with NaP, but was transient, and no concomitant decrease in calcium was seen. We conclude that, in the groups of patients studied, 90-ml NaP is a safe colonic cleansing agent that is better tolerated and more effective than others.

Administration, Oral↗
PubMed1998

The role of colonoscopy in coloproctological practice.

Colonoscopy has completely changed the practice of colorectal surgery. It has both diagnostic and therapeutic roles. In diagnosis, it allows direct visualization of the colon and taking of tissue biopsies for histology. The commonest therapeutic manoeuvre is polypectomy for bleeding. Colonoscopy is safe and, where facilities exist, it should be used as first-line investigation of colorectal disorders.

Colon↗
PubMed1979

The management of suspected tumours of the colon: the role of colonoscopy in general surgery.

The role of colonoscopy in the management of 100 cases of suspected large bowel tumour is described. Forty out of 47 patients with an equivocal barium enema examination were satisfactorily examined and the possibility of a tumour being present was either confirmed or refuted. Examination of 30 patients with otherwise unexplained blood loss from the bowel revealed the cause in 50 per cent of them. Twenty-nine patients had pedunculated polyps which were snared and removed, thus avoiding laparotomy and colotomy. The problem of distinguishing tumours from other lesions or retained faeces by radiology arises most often in the sigmoid colon. This segment is easily examined using a short flexible endoscope. General surgeons taking up colonoscopy will find a 1-m single-channel instrument convenient to use and capable of reaching approximately 90 per cent of colonic tumours that require further investigation or endoscopic resection. Facilities for the examination of the whole colon should be available in established endoscopy units.

Adult↗
PubMed2004

Perforated colon secondary to virtual colonoscopy: report of a case.

We describe a case of a perforated colon secondary to a virtual colonoscopy in an 81-year-old female with ulcerative colitis. She underwent an emergent right hemicolectomy. The pathologic findings were described as ulcerative colitis with full-thickness perforation. To the best of our knowledge, this is the first complication from a virtual colonoscopy reported in the literature.

Aged↗
PubMed2005

Virtual colonoscopy: issues related to primary screening.

Virtual colonoscopy (VC) is a minimally invasive CT examination that has continued to rapidly evolve and improve as a diagnostic screening tool. Current state-of-the-art VC technique has already been shown to be highly effective for screening at the University of Wisconsin. Although more widespread implementation of VC screening faces multiple challenges and barriers, these are all greatly overshadowed by the immediate need for increased patient compliance in effective colorectal screening programs. Given the wide availability of CT and the favorable safety profile compared with optical colonoscopy, VC holds significant potential for addressing a very important yet preventable public health concern. This paper will briefly address some of the major issues related to the general application of VC for colorectal screening, such as diagnostic performance, development of an acceptable screening algorithm, and several technique-related issues.

Algorithms↗
PubMed1978

Colonoscopy and polypectomy.

An overview of colonoscopy and polypectomy is presented. The merits of this procedure are pointed out, highlighting the newer technics and those technics that have survived. The complications of colonoscopy and polypectomy are reviewed in detail.

Colon↗
PubMed2006

Virtual colonoscopy in the detection of colonic polyps and neoplasms.

First introduced in 1994, CT colonography (Virtual colonoscopy) has emerged as an accurate, non-invasive test that will likely play a future role in colorectal cancer screening. Over the past 3 years, there have been dramatic improvements in both hardware and software technology relating to CT colonography resulting in shorter scan times, enhanced user-friendliness and improved performance statistics. Published results show the accuracy of CT colonography to be comparable to conventional colonoscopy for detection of polyps >6mm in size with few false-positives. While many of the technical aspects of CT colonography have now been standardised current interest focuses on the development of faecal tagging agents to avoid full bowel catharsis and the use of low dose multislice CT acquisition to reduce patient radiation exposure. This chapter will summarise the development of CT colonography to date, document its published performance in detection of colorectal polyps and cancers, and review its current and potential future uses.

Colonic Neoplasms↗
PubMed2005

Virtual colonoscopy by MRI: state-of-the-art and future directions.

MR colonography has been shown to be an appropriate diagnostic tool for the detection of colorectal lesions. The technique is based on the acquisition of T1-weighted sequences after the administration of water enema and the intravenous administration of paramagnetic contrast. This article describes the technical requirements for MR colonoscopy and the procedures of data acquisition and image interpretation. The advantages and drawbacks of MR colonoscopy also are outlined.

Colonic Polyps↗
PubMed1980

Colonoscopy in radiation colitis.

Colonoscopy in 13 patients with stenosis or hemorrhage after radiation therapy is correlated with clinical and radiographic features. The authors found colonoscopy helpful in delineating the diagnosis and in guiding treatment.

Aged↗
PubMedDate not supplied

Usefulness of pediatric colonoscopes in adult colonoscopy.

Use of small diameter, extraflexible pediatric colonoscopes has proved to be valuable in adult endoscopy practice, not only for passing strictures and stomas but also where either fixation due to diverticular disease or postoperative adhesions, or unavoidably painful looping made passage of adult colonoscopes impossible. In 70 of 78 (92%) of the cases where the adult colonoscope could not be passed through the sigmoid colon by an expert endoscopist, the pediatric colonoscope passed through, often very easily. Fifteen of these patients were considered to have been saved surgery by successful passage. The "failure" rate for all colonoscopy examinations was only 2%; this low failure rate was attributable to the use of pediatric instruments whenever passage through the sigmoid colon proved to be impossible with standard colonoscopes. In our opinion every unit performing frequent colonoscopies should have a pediatric colonoscope available for selected adult patients as well as for use in children.

Biopsy↗
PubMed1996

Use of a pediatric colonoscope improves the success of total colonoscopy in selected adult patients.

BACKGROUND: Colonoscopy using a standard adult colonoscope can be difficult or impossible when there is a fixed, angulated sigmoid colon or stricture. It is sometimes possible to traverse such segments using a smaller-diameter, more flexible pediatric colonoscope. METHODS: For this prospective study, one endoscopist started 645 consecutive, elective colonoscopies with a standard adult Olympus CF-100L colonoscope (52% women, 48% men). There were 36 examinations (5.6%) in which the adult colonoscope could not be passed through a fixed, angulated sigmoid colon (n = 34) or a sigmoid colonic stricture (n = 2). In such instances (33 women and 3 men), the endoscopist switched to a pediatric colonoscope. RESULTS: The pediatric colonoscope successfully reached the cecum in 21 of the 36 cases (58.3%). The figure was 38.5% for the older Olympus CF-P20L fiberoptic colonoscope (n = 13) and 69.6% for the newer Olympus PCF-100 videocolonoscope (n = 23). Concomitant conditions in the 34 patients in whom the pediatric colonoscope was used because of a fixed, angulated sigmoid included previous pelvic surgery in 22, pelvic radiation therapy in 2, pelvic endometriosis in 3, and two with previous sigmoid diverticulitis. CONCLUSIONS: The pediatric colonoscope, and particularly the newer Olympus PCF-100 colonoscope, is very useful in adult patients in whom it is not possible to traverse a fixed, angulated sigmoid colon or stricture using the standard adult colonoscope. This is predominantly a problem of female patients. Previous pelvic surgery may be an important causative factor in this regard.

Colon↗
PubMed1978

Colitis, cancer, and colonoscopy.

Colonoscopy has added a new dimension to the diagnosis of colonic diseases. In the field of inflammatory bowel disease, colonscopy is indicated only when certain specific problems arise. Patients with acute colitis and those who are too sick to withstand cleansing enemas should not undergo colonoscopy. A major use of the colonoscope is in the detection of carcinoma in the colitic colon either in the form of colonic strictures or filling defects discovered by barium enema x-ray, or in the long-term surveillance of patients with universal ulcerative colitis. Criteria are listed to assist in the colonoscopic differential diagnosis between ulcerative and granulomatous colitis. By using different criteria than the radiographer, and with the help of biopsy specimens, a high degree of accuracy in proper diagnosis can be achieved.

Colitis↗
PubMed2002

The virtual colonoscopy study: a large multicenter clinical trial designed to compare two diagnostic screening procedures.

This paper reviews the design of a large multicenter clinical trial currently being conducted to test the equivalence of two screening procedures for colorectal polyps. The primary outcome is the sensitivity and specificity of the new and standard procedures for detecting subjects with and without polyps of a size > or =6 mm, respectively. An important secondary outcome is the accuracy of these procedures in detecting individual polyps. A total of 619 participants underwent virtual colonoscopy, the new procedure, followed by conventional colonoscopy, the standard procedure. Strategies for the design and implementation of the study are shared as well as the challenges encountered.

Bias↗
PubMed2001

Improving the results of virtual colonoscopy: what the future will bring.

Several studies show the possibility of using virtual colonoscopy in radiologic routine. To understand what its future holds, a deep insight into the techniques and pitfalls is mandatory. Currently, patient preparation and insufflation methods have to be improved because they represent the main source of pitfalls. Acquisition techniques currently provide only morphologic information, which is inadequate in the case of flat lesions. Functional information is needed but not yet available. Although the development of postprocessing techniques during the past few years has been rapid, virtual colonoscopy cannot yet be proposed as a screening technique. State-of-the-art technology, however, allows us to imagine that in the near future it will become a tool suitable for routine application.

Colonic Neoplasms↗
PubMed2001

The outcome of esophagogastroduodenoscopy (EGD) in asymptomatic outpatients with iron deficiency anemia after a negative colonoscopy.

Background: Both iron deficiency and iron deficiency anemia require extensive investigation because of their possible association with gastrointestinal malignancy. If no other sources of blood loss are apparent, the gastrointestinal tract is examined to detect sources of occult blood loss. In the absence of gastrointestinal symptoms, the colon is first examined, especially in the elderly. The aim of this study was to determine the outcome of esophagogastroduodenoscopy (EGD) after a prior negative colonoscopy in outpatients without gastrointestinal complaints, referred due to iron deficiency anemia. Methods: Thirty-five patients (22 female and 13 male) with a median age of 71 years were studied over a 2-year period. Anemia was defined as a hemoglobin (Hb) level below 7.4 mmol/l in women or below 8.0 mmol/l in men and iron deficiency if one of the following was present: ferritin level equal to or below 20 µg/l for men and equal to or below 10 µg/l for women, a serum iron concentration equal to or below 45 µg/dl (8.1 µmol/l) with a transferrin saturation of 10% or less, or the absence of iron stores in bone marrow biopsy specimens. Patients with prior gastrointestinal disease or surgery, gastrointestinal symptoms, or other obvious causes of blood loss were excluded. Lesions that were considered to be potential sources of blood loss were clearly defined. Results: The mean Hb level of the 35 patients studied was 5.5 mmol/l (range 1.8-7.8 mmol/l). Abnormalities were found in 10 patients (28.6%), all of which were benign. Erosive and ulcerative lesions in the stomach, in a hiatal hernia, or in the esophagus were diagnosed in eight patients, benign villous adenoma was seen in one patient, and celiac disease in another, although duodenal biopsies were taken in only 15 patients. Erosions and/or ulcerations were found in four of 11 patients (36%) using NSAIDs and/or salicylates (ASA). Seventy percent of the lesions were found in elderly patients (>65 years), 56% of whom were using NSAIDs and/or ASA. Conclusions: EGD should always be performed in patients with iron deficiency anemia after a negative colonoscopy, although upper gastrointestinal malignancy will probably be an infrequent finding. The presence of a significant, treatable lesion is most likely in the elderly and in those with a history of NSAID or ASA use. Routine duodenal biopsies should be performed to further increase the outcome of EGD.

Journal Article↗