Overview of Endoscopic Features of Gastrointestinal Pathology (Colon)

  • Ammar O. Kheir
  • Nicholas J. Tutticci
  • David G. HewettEmail author


Advances in endoscopic imaging technologies and techniques in recent decades have revolutionized the detection, diagnosis, and therapy of gastrointestinal pathology. New-generation endoscope systems produce high-definition images with over a million pixels that are three times higher in resolution than standard-definition images produced by older-generation endoscope systems. In addition, endoscopic image contrast can be enhanced with stains, and electronic imaging technologies such as narrow-band imaging (NBI, Olympus Corporation, Tokyo, Japan). These technologies are known collectively as “image-enhanced endoscopy,” which are known to improve the detection and facilitate real-time optical diagnosis or characterization of early gastrointestinal neoplasia. Optical diagnosis therefore improves tissue sampling for subsequent histologic evaluation and also enables real-time selection of appropriate endoscopic therapy for early gastrointestinal neoplasia while and avoiding unnecessary surgery. In this chapter, we present an overview of endoscopic features of colorectal pathology.


Colonoscopy Optical diagnosis Colorectal Narrow-band imaging Adenoma 


  1. 1.
    American Society for Gastrointestinal Endoscopy Standards of Practice C, Shergill AK, Lightdale JR, Bruining DH, Acosta RD, Chandrasekhara V, et al. The role of endoscopy in inflammatory bowel disease. Gastrointest Endosc. 2015;81(5):1101-21.e1–13.Google Scholar
  2. 2.
    Laine L, Kaltenbach T, Barkun A, McQuaid KR, Subramanian V, Soetikno R, et al. SCENIC international consensus statement on surveillance and management of dysplasia in inflammatory bowel disease. Gastroenterology. 2015;148(3):639–51.e28.PubMedCrossRefGoogle Scholar
  3. 3.
    Laine L, Kaltenbach T, Barkun A, McQuaid KR, Subramanian V, Soetikno R, et al. SCENIC international consensus statement on surveillance and management of dysplasia in inflammatory bowel disease. Gastrointest Endosc. 2015;81(3):489–501.e26.PubMedCrossRefGoogle Scholar
  4. 4.
    DuPont HL. Bacterial diarrhea. N Engl J Med. 2009;361(16):1560–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Kheir AO, Kaltenbach T, Soetikno R. Chromoendoscopy. In: Vani KJA, Waxman I, editors. Endoscopic imaging techniques and tools. New York, NY: Springer International Publishing; 2016. p. 29–48.Google Scholar
  6. 6.
    Kaltenbach T, Sano Y, Friedland S, Soetikno R, American Gastroenterological A. American Gastroenterological Association (AGA) Institute technology assessment on image-enhanced endoscopy. Gastroenterology. 2008;134(1):327–40.PubMedCrossRefGoogle Scholar
  7. 7.
    Committee AT, Abu Dayyeh BK, Thosani N, Konda V, Wallace MB, Rex DK, et al. ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps. Gastrointest Endosc. 2015;81(3):502.e1–e16.CrossRefGoogle Scholar
  8. 8.
    Hewett DG, Kaltenbach T, Sano Y, Tanaka S, Saunders BP, Ponchon T, et al. Validation of a simple classification system for endoscopic diagnosis of small colorectal polyps using narrow-band imaging. Gastroenterology. 2012;143(3):599–607.e1.PubMedCrossRefGoogle Scholar
  9. 9.
    Sakata S, Kheir AO, Hewett DG. Optical diagnosis of colorectal neoplasia: a western perspective. Dig Endosc. 2016;28(3):281–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Hayashi N, Tanaka S, Hewett DG, Kaltenbach TR, Sano Y, Ponchon T, et al. Endoscopic prediction of deep submucosal invasive carcinoma: validation of the narrow-band imaging international colorectal endoscopic (NICE) classification. Gastrointest Endosc. 2013;78(4):625–32.PubMedCrossRefGoogle Scholar
  11. 11.
    The Paris classification of superficial neoplastic lesions: esophagus, stomach, and colon. Gastrointest Endosc. 2003;58(Supp):S3–S43.Google Scholar
  12. 12.
    Kudo S, Tamura S, Nakajima T, et al. Diagnosis of colorectal tumorous lesions by magnifying endoscopy. Gastrointest Endosc. 1996;44:8–14.PubMedCrossRefGoogle Scholar
  13. 13.
    IJspeert JE, Bastiaansen BA, van Leerdam ME, Meijer GA, van Eeden S, Sanduleanu S, et al. Development and validation of the WASP classification system for optical diagnosis of adenomas, hyperplastic polyps and sessile serrated adenomas/polyps. Gut. 2016;65:963.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Ammar O. Kheir
    • 1
    • 2
  • Nicholas J. Tutticci
    • 1
    • 2
  • David G. Hewett
    • 1
    • 2
    Email author
  1. 1.Faculty of MedicineUniversity of QueenslandBrisbaneAustralia
  2. 2.Department of EndoscopyQueen Elizabeth II Jubilee HospitalBrisbaneAustralia

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