Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
CHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2 use of the gastrocamcra under fluoroscopic control, and sultseqiienlly Niwa's development of the "sig-mocamcra.' Not surprisingly, these instruments had application only in the hands of pioneer enthusiasts. Following Hirsc howilz's development of the fiberoptic bundle in 1957 I960 for use in protot Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2ype side-viewing gasl roseopes, several colorectal enthusiasts Started developments. The first was Overholt in the USA, who started on prototypes illEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
1961, performed the first fiberoptic flexible sigmoidoscopy in 1963, and finally introduced a commercial forward-viewing short "fiberoptic coIoscope' CHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2olon with passive fiberoptic- viewing bundles or side-viewing gastroscopcs inserted through a tube placed radiologically or pulled up by a swallowed Iransinleslinal "guide string and pulley' system.In 1969 Western researchers were surprised by the production by Japanese engineers (Olympus Optical an Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2d Mac hida) of remarkably effective colonoscopcs. which combined the precise two-way angulation arid torque-stable shall of the latest gaslrocameras wEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
ith superior fiberoptic bundles, although initially the limitations of Japanese glassfiber technology restricted angulation to around 90“ (due to fragCHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2neered in 1971 by Dcyhlc in Europe and shinya in the USA.In the mid-1970s four-way ac utely angulating instruments were introduced, and in 1983 the video endoscope arrived (Welch-Allyn. USA). Although small-scalecolonoscopeproduction continued fora time in the USA, Germany, Russia, and China, the co Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2mbined mechanical, optical, and electronic know-how of the Japanese camera manufacturers now controls the conventional colonoscopc market.IndicationsEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
and limitationsThe place of colonoscopy in clinical practice depends on local circumstances and available endoscopic expertise. Although colonos-CottoCHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2, and Christopher B Williams.© 2014 John Wiley & Sons. Ltd. Published 2014 by John Wiley & Sons, Ltd.Companion Website: www.wiley.com/go/cottonwilliams/practicalgastroenterology78Practical Gastrointestinal Endoscopy 79copy is considered the 'gold standard" exam, 'virtual" colography by computed tomo Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2graphy (CT) or even double-contrast barium enema (DCBE) alone may be considered by some to be adequate in "low-yield" patients where therapeutic interEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
vention, histology, or line-focus diagnosis is not needed. Similarly, on the grounds of logistics, safety, and patient acceptability, flexible sigmoidCHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2ening in the UK.Double-contrast barium enemaDCBF is a safe (one perforation per 25 000 examinations) way of showing the configuration of the colon, the presence of diverticular disease, and the absence of strictures or large lesions. However, even high-quality DCBE has significant limitations, inclu Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2ding missing large lesions because of overlapping k»ops (particularly in the sigmoid region), to misinterpreting between solid stool and neoplasm or bEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
etween spasm and strictures, with particular inaccuracy for Hal lesions such as angiodysplasia or minor inflammatory change and small (2 5 mm) polyps,CHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2th pain, altered bowel habit or constipation; it also shows extramural leaks or fistulac, which arc invisible to the endoscopist.Computed tomography colographyCT colography ("virtual colonoscopy*) has replaced barium enema as the radiological investigation of choice for the colon, with the advantage Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2s ol being quicker arid not filling the colon with dense contrast medium. CT colography does recpiire technical expertise of the radiographer in perfoEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
ming it and the radiologist who interprets it, A few patients who are very difficult to colonoscope lor reasons of anatomy or postoperative adhesions CHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2hology—with virtual colography or barium enema to demonstrate the proximal colon. Virtual colography has the advantage that it can be performed before or after colonoscopy and with the same bowel preparation, although the majority of procedures arc now performed with limited or no bowel preparation Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2and "faecal lagging" using water-soluble contrast agents. CT colography requires radiation dosage comparable to that of DC1ỈE, although dedicated CT pEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
rotocols limit radiation as much as possible.Colonoscopy and flexible sigmoidoscopyColonoscopy and flexible sigmoidoscopy achieve more than contrast rCHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2scopy particularly relevant to patients with bleeding, anemia, bowel frequency, or diarrhea. Flexible sigmoidoscopy alone may be sufficient for some patients, such as those with left iliac fossa pain or bright red pcr-rcơal bleeding.80 Colonoscopy and Flexible SigmoidoscopyTable 6.1 Colonoscopy: ind Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2ications and yield.High-yield indicationsLow-yield indicationsAnemia/bleedingfoccult blood loss Persistent diarrhea Inflammatory disease assessment GeEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
netic cancer risk Abnormality on imaging TherapyConstipation Flatulence Altered bowel habit PainBecause of near pinpoint accuracy and therapy, colonosCHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2predictor of long-term risk. Colonoscopy is thus the method of choice lor many clinical indications and lor cancer surveillance examinations and follow-up (Table 6.1). Endoscopy is also particularly useful in the postoperative patient, cither to inspect in close-up (and biopsy il necessary) any defo Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2rmity at the anastomosis or to avoid the difficulties of achieving adequate distension in patients with a stoma.Combined proceduresThe combination ofEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
two procedures (colonoscopy and virtual holography or DCRF) has potential advantages. If carbon dioxide (CO?) insufflation is used for colonoscopy or CHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2 of virtual colography, it is an ideal procedure to combine with colonoscopy. DCBE tan be made difficult if the proximal colon is already air-filled, so problematic to fill and coat with barium. Colonoscopic biopsies with standard-sized foneps are no contraindication to distending the colon for subs Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2equent DCBL or CT colog-raphy. Pedunculated polypectomy should also be sale, but the likelihood of deep electrocoagulation during sessile polypectomy,Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
however small, contraindicates use of distension pressure. DCBE perforation is rare, but barium peritonitis can be fatal.Limitations of colonoscopy•ICHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2 ilco-cccal valve is reached and positively identified with clear views of the cecal pole, completion has not been proved.•Gross errors in colonoscopic localization and ~blind spots" are possible even for expert endoscopists. Blind areas, with the possibility of missing very large lesions, occur esp Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2ecially in the cecum, around acute bends and in the rectal ampulla. Colonoscopic examination, rigorously performed, can probably approach 90% accuracyEbook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2
lor small lesions, but will never be 100%. A 'back to back" colonoscopy scries, in which the patient was colonoscopcd twicePractical GastrointestinalCHAPTER 6Colonoscopy and Flexible SigmoidoscopyHistoryThe history ol colonoscopy (Video 6.1) started ill 1958 in .Japan with Matsunaga's intracolonic Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2chagrin OÍ seeing a large polyp during insertion, but missing it entirely during withdrawal when the colon is crumpled after straightening the scope.Hazards, complications, and unplanned events Ebook Cotton and Williams’ practical gastrointestinal endoscopy - The fundamentals: Part 2Gọi ngay
Chat zalo
Facebook