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Endoscopy

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The ASCRS Textbook of Colon and Rectal Surgery

Abstract

The endoscopic evaluation of the patient with colorectal complaints forms the keystone of the physical examination. These examinations allow for the visualization of the entire intestinal tract and include anoscopy, proctoscopy, and colonoscopy as well as PillCam endoscopy. The indications for performing a colonoscopy are multiple, yet there is debate regarding the appropriateness of performing the procedure in some clinical scenarios. The bowel prep is of critical importance in order to adequately examine the entire colon, with inadequate cleaning reported in up to 27 % of patients. Splitting the timing of the prep into one half the day prior to and half the day of the procedure results in a better prep results. There are several adjunctive maneuvers employed with endoscopy that often serve as the markers between seasoned experts and novices. There are alternate techniques, as well, including CO2 insufflation, Narrow Band Imaging (NBI) endoscopy, and chromoendoscopy. The 30-day complication rate of colonoscopy is low, ranging from 1 to 5 per 1000 examinations. There is debate on the adequate training required before someone is competent to independently perform colonoscopy, and inadequate documentation following the procedure is common. PillCam endoscopy is most commonly employed for patients with occult gastrointestinal bleeding or in the search for other small bowel pathology, such as insipient tumors, polyposis syndromes, or Crohn’s disease.

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Authors and Affiliations

  1. Department of Surgery, William Beaumont Army Medical Center, 5005 N. Piedras St, El Paso, TX, 79920, USA

    Kurt Davis MD

  2. Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA

    Michael A. Valente DO, FACS, FASCRS

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  1. Kurt Davis MD
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Correspondence to Kurt Davis MD .

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Editors and Affiliations

  1. Division of Colorectal Surgery, University Hospitals Case Medical Center Case Western Reserve University, Cleveland, OH, USA

    Scott R. Steele

  2. Cleveland Clinic, Cleveland, OH, USA

    Tracy L. Hull

  3. Tufts University School of Medicine, Lahey Hospital & Medical Center, Burlington, MA, USA

    Thomas E. Read

  4. Ambrose and Gladys Bowyer, Loyola University, Chicago, IL, USA

    Theodore J. Saclarides

  5. University of Texas Medical Branch at Galveston, Galveston, TX, USA

    Anthony J. Senagore

  6. Ochsner Medical Center, New Orleans, LA, USA

    Charles B. Whitlow

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Davis, K., Valente, M.A. (2016). Endoscopy. In: Steele, S.R., Hull, T.L., Read, T.E., Saclarides, T.J., Senagore, A.J., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-25970-3_4

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