Generally accepted indications for diagnostic colonoscopy are summarized in Table 54.1. Colonoscopy is usually not indicated in patients with bright red rectal bleeding when a convincing anorectal source has been found on anoscopy or sigmoidoscopy and when there are no other symptoms suggesting a more proximal source of bleeding. It is also not necessary in upper gastrointestinal bleeding when a source proximal to the colon has been clearly identified. Colonoscopy is generally not indicated in the workup of metastatic carcinoma in the absence of symptoms related to the colon. Colonoscopy is indicated for evaluation of unexplained abdominal pain or change in bowel habits only in select cases. It is generally not indicated in patients with chronic stable abdominal pain or symptoms of irritable bowel in the absence of other indications for colonoscopy.
KeywordsRectal Cancer Sigmoid Colon Splenic Flexure Biopsy Forceps Diagnostic Colonoscopy
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