Lower Gastrointestinal Endoscopy

  • P. H. Wiesel
  • J. Hess
  • G. Dorta


Colonoscopy is currently the examination of choice for evaluating diseases of the colon, sigmoid, rectum, and terminal ileum. The examination is tolerated as well as barium enemas. In addition to the improved diagnostic capability of colonoscopy compared to barium enemas, endoscopy has the advantage of allowing small lesions to be treated during the diagnostic procedure [9,29,48].


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  1. 1.
    Alberti-Flor JJ, Hernandez ME, Ferrer JP (1992) Combined injection and thermal therapy in the management of early post-polypectomy bleeding. Am J Gastroenterol 87(11):1681–1682PubMedGoogle Scholar
  2. 2.
    Alfa MJ, Sitter DL (1994) In-hospital evaluation of ortho-phthalaldehyde as a high level disinfectant for flexible endoscopes. J Hosp Infect 26(1): 15–26PubMedCrossRefGoogle Scholar
  3. 3.
    American Society for Gastroenterological Endoscopy (ASGE) (1994) Technology assessment status evaluation: electocautery use in patients with implanted cardiac devices. Gastrointest Endosc 40(6):794–795Google Scholar
  4. 4.
    American Society for Gastrointestinal Endoscopy (ASGE) (1995) Antibiotic prophylaxis for gastrointestinal endoscopy. Gastrointest Endosc 42:630CrossRefGoogle Scholar
  5. 5.
    Andrus CH (1994) Exploratory laparoscopy for perforation following colonoscopy. Surg Laparosc Endosc Aug 4(4):327Google Scholar
  6. 6.
    Arrowsmith JB, Gerstman BB, Fleischer DE et al (1991) Results from the American Society for Gastroenterological Endoscopy/U.S. FDA collaborative study. Gastrointest Endosc 37:421–427PubMedCrossRefGoogle Scholar
  7. 7.
    Bac DJ, van Blankenstein M, Deie S et al (1994) Peritonitis following endoscopic polypectomy in a peritoneal dialysis patient: the need for antibiotic prophylaxis. Infection 22(3):220–221PubMedCrossRefGoogle Scholar
  8. 8.
    Berger D, Boelke E, Stanescu A et al (1995) Endotoxemia and mediator release during colonoscopy. Endoscopy 27:671–675PubMedCrossRefGoogle Scholar
  9. 9.
    Brady AP, Stevenson GW, Stevenson I et al (1994) Colorectal cancer overlooked at barium enema examination and colonoscopy: a continuing perceptual problem. Radiology 192:373–378PubMedGoogle Scholar
  10. 10.
    Cappell MS, Ghandi D, Huh C (1995) A study of the safety and clinical efficacy of flexible sigmoidoscopy and colonoscopy after recent colonic surgery in 52 patients. Am J Gastroenterol 90(7):1130–1134PubMedGoogle Scholar
  11. 11.
    Carpio G, Albu E, Gumbs MA et al (1989) Management of colonic perforation after colonoscopy: report of three cases. Dis Colon Rectum 32:624–626PubMedCrossRefGoogle Scholar
  12. 12.
    Cass OW, Freemann ML, Peine CJ et al (1993) Objective evaluation of endoscopy skills during training. Ann Int Med 118:40–44PubMedCrossRefGoogle Scholar
  13. 13.
    Cataldo PA (1996) Colonoscopy without sedation. Dis Colon Rectum 39(3):257–261PubMedCrossRefGoogle Scholar
  14. 14.
    Chardavoyne R, Wise L (1994) Exploratory laparoscopy for perforation following colonoscopy. Surg Laparosc Endosc 4(3):241–243PubMedGoogle Scholar
  15. 15.
    Charnley RM, Campbell G, Robinson MH et al (1992) Colonic perforation during colonoscopy. Br J Surg 79(3):282PubMedCrossRefGoogle Scholar
  16. 16.
    Christ AD, Bauerfeind P, Gyr N (1993) Peritonitis after colonoscopy in a patient with ascites. Endoscopy 25(8):553–554PubMedCrossRefGoogle Scholar
  17. 17.
    Christie JP, Marazzo J (1991) ”Mini perforation” of the colon. Not all post-polypectomy perforations require laparotomy. Dis Colon Rectum 34:132–135PubMedCrossRefGoogle Scholar
  18. 18.
    Church JM (1994) Complete colonoscopy: how often? And if not, why not? Am J Gastroenterol 89(4):556–560PubMedGoogle Scholar
  19. 19.
    Clarkston WK, Tsen TN, Dies DF et al (1996) Oral sodium phosphate versus sulfate-free polyethylene glycol electrolyte lavage solution in outpatient preparation for colonoscopy: a prospective comparison. Gastrointest Endosc 43:42PubMedCrossRefGoogle Scholar
  20. 20.
    Clavien PA, Sanabria JR, Strasberg S (1992) Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 111(5):518–526PubMedGoogle Scholar
  21. 21.
    Cohen SM, Wexner SD, Binderow SR et al (1994) Prospective, randomized, endoscopic-blinded trial comparing precolonoscopy bowel cleansing methods. Dis Colon Rectum 37:68 9Google Scholar
  22. 22.
    Coman E, Brandt LT, Brenner S et al (1991) Fat necrosis and inflammatory pseudotumor due to endoscopic tattooing of the colon with India ink. Gastrointest Endosc 37:65–68PubMedCrossRefGoogle Scholar
  23. 23.
    Cotton PB (1994) Outcomes of endoscopic procedure: struggling towards definitions. Gastrointest Endosc 40(4):514–518PubMedCrossRefGoogle Scholar
  24. 24.
    Dajani AS, Bison Al, Chung KJ et al (1990) Prevention of bacterial endocarditis. Recommendations by the American Heart Association. JAMA 264:29–19CrossRefGoogle Scholar
  25. 25.
    Diprima RE, Barkin JS, Blinder M et al (1988) Age as a risk factor in colonoscopy. Fact versus fiction. Am J Gastroenterol 83:123–125PubMedGoogle Scholar
  26. 26.
    Dolce P, Gourdeau M, April N, et al (1995) Outbreak of glutaraldehyde-induced proctocolitis. Am J Infect Control 23:34–39PubMedCrossRefGoogle Scholar
  27. 27.
    Eckardt VF, Stamm H, Kanzler G, Bernard G. (1994) Improved survival after colorectal cancer in patients complying with a prospective endoscopic surveillance program. Endoscopy 26:523–527PubMedCrossRefGoogle Scholar
  28. 28.
    Eckhauser ML (1992) Laser therapy of gastrointestinal tumors. World J Surg 16:1054–1059PubMedCrossRefGoogle Scholar
  29. 29.
    Elliot MS, Levenstein JH, Wright JP (1984) Foecal occult blood testing in the detection of colorectal cancer. Br J Surg 71:785–786PubMedCrossRefGoogle Scholar
  30. 30.
    Fleischer DE (1994) Better definitions of endoscopic complications and other negative outcomes. Gastrointest Endosc 40(4):511–513PubMedCrossRefGoogle Scholar
  31. 30a.
    Fleischer DE (1994) Better definitions of endoscopic complications and other negative outcomes. Gastrointest Endosc 40(4):493–500CrossRefGoogle Scholar
  32. 31.
    Fleischer DE, Al-Kawas F, Benjamin S et al (1992) Prospective evaluation of complications in an endoscopy unit: use of the ASGE quality care guidelines. Gastrointest Endosc 38:411–414PubMedCrossRefGoogle Scholar
  33. 32.
    Fraser VJ, Zuckerman G, Clouse RE et al (1993) A prospective randomized trial comparing manual and automated endoscope disinfection methods. Infect Control Hosp Epidemiol 14(7):383–389PubMedCrossRefGoogle Scholar
  34. 33.
    Froehlich F, Gonvers JJ, Fried M (1994) Conscious sedation, clinically relevant complications and monitoring of endoscopy: results of a nationwide survey in Switzerland. Endoscopy 26(2):231–234PubMedCrossRefGoogle Scholar
  35. 34.
    Ghazi A, Grossman M (1982) Complications of colonoscopy and polypectomy. Surg Clin North Am 62:889–896PubMedGoogle Scholar
  36. 35.
    Goh PM, Kum CK, Chia YW et al (1994) Laparoscopic repair of perforation of the colon during colonoscopy. Gastrointest Endosc 40(4):496–497PubMedCrossRefGoogle Scholar
  37. 36.
    Habr-Gama A, Waye JD (1989) Complications and hazards of gastrointestinal endoscopy. World J Surg 13:193–201PubMedCrossRefGoogle Scholar
  38. 37.
    Hall V, Dorricott NJ, Donovan IA et al (1991) Colon perforation during colonoscopy: surgical versus conservative management. Br J Surg 78(5):542–544PubMedCrossRefGoogle Scholar
  39. 38.
    Hawes R, Lehman GA, Hast J et al (1986) Training resident physicians in flexible sigmoidoscopy: how many supervised examinations are required to achieve competence? Am J Med 80:465–470PubMedCrossRefGoogle Scholar
  40. 39.
    Hawes RH, Wiersema MJ (1993) Role of endoscopy in the staging of colorectal carcinoma. Endoscopy 25:101–107PubMedCrossRefGoogle Scholar
  41. 40.
    Henderson JM, Barnett JI, Kim Turgon D et al (1995) Single-day, divided-dose oral sodium phosphate laxative versus intestinal lavage as preparation for colonoscopy: efficacy and patient tolerance. Gastrointest Endosc 42:238PubMedCrossRefGoogle Scholar
  42. 41.
    Herman LL, Kurtz RC, McKee KJ et al (1993) Risk factors associated with vasovagal reactions during colonoscopy. Gastrointest Endosc 39(3):388–391PubMedCrossRefGoogle Scholar
  43. 42.
    Iber FL, Sutberry M, Gupta R et al (1993) Evaluation of complications during and after conscious sedation for endoscopy using pulse oximetry. Gastrointest Endosc 39(5):620–625PubMedCrossRefGoogle Scholar
  44. 43.
    Idseo O, Guthe T, Willcox RR et al (1986) Nature and extent of penicillin side-reactions, with particular reference to fatalities from anaphylactic shock. Bull World Health Org 38:15/9Google Scholar
  45. 44.
    Jaffe PE, Fennerty MB, Sampliner RE et al (1992) Preventing hypoxemia during colonoscopy. A randomized controlled trial of supplemental oxygen. J Clin Gastroenterol 14(2):114–116PubMedCrossRefGoogle Scholar
  46. 45.
    Jentschura D, Raute M, Winter J et al (1994) Complications in endoscopy of the lower gastrointestinal tract. Therapy and prognosis. Surg Endosc 8(6):672–676PubMedCrossRefGoogle Scholar
  47. 46.
    Kaczmarek RG, Moore RM Jr, McCrohan J et al (1992) Multi-state investigation of the actual disinfection/sterilization of endoscopes in health care facilities. Am J Med 92:257–261PubMedCrossRefGoogle Scholar
  48. 47.
    Kavin H, Sinicrope F, Esker AH (1992) Management of perforation of the colon at colonoscopy. Am J Gastroenterol 87(2):161–167PubMedGoogle Scholar
  49. 48.
    Kewenter J Breringe H, Engaras B et al (1997) The value of flexible sigmoidoscopy and double-contrast barium enema in the diagnosis of neoplasms in the rectum and colon in subjects with a positive hemoccult: results of 1831 rectosig-moidoscopies and double-contrast barium enemas. Endoscopy 27:1599–6163Google Scholar
  50. 49.
    Kolts BE, Lyes WE, Achem SR et al (1993) A comparison of the effectiveness and patient tolerance of oral sodium phosphate, castor oil, and standard electrolyte lavage for colonoscopy or sigmoidoscopy preparation. Am J Gastroenterol 88:12–18Google Scholar
  51. 50.
    Kozarek RA, Earnest DL, Siverstein ME et al (1980) Air-pressure-induced colon injury during diagnostic colonoscopy. Gastroenterology 78:71–4Google Scholar
  52. 51.
    Lazzaroni M, Bianchi Porro G (1996) Preparation, premedication and surveillance. Endoscopy 28:6CrossRefGoogle Scholar
  53. 52.
    Lee JG (1995) Supplemental oxygen during endoscopy in patients with ischemic heart disease. Gastrointest Endosc 42(3):275PubMedCrossRefGoogle Scholar
  54. 53.
    Levine EG, Brandt LJ, Plumeri P (1995) Informed consent: a survey of physician outcomes and practices. Gastrointest Endosc 41:448–452PubMedCrossRefGoogle Scholar
  55. 54.
    Lo AY, Beaton HL (1994) Selective management of colonoscopic perforations. J Am Coll Surg 179(3):333–337PubMedGoogle Scholar
  56. 55.
    Luchette FA, Doerr RJ, Kelly K et al (1992) Colonoscopic impaction in left colon strictures resulting in right colon pneumatic perforation. Surg Endosc 6(6):273–276PubMedCrossRefGoogle Scholar
  57. 56.
    Macrae FA, Tan KG, Williams CB (1983) Towards safer colonoscopy. A report of the complications of 5000 diagnostic and therapeutic colonoscopies. Gut 24:76–83CrossRefGoogle Scholar
  58. 57.
    Nivatvong S (1986) Complications in colonoscopic polypectomy. An experience with 1 555 polypectomies. Dis Colon Rectum 29:825–830CrossRefGoogle Scholar
  59. 58.
    Norfleet R (1991) Infectious endocarditis after fiberoptic sigmoidoscopy. J Clin Gastroenterol 84:448CrossRefGoogle Scholar
  60. 59.
    Nugent FW, Haggitt RC, Gilpin PA (1991) Cancer surveillance in ulcerative colitis. Gastroenterology 100:1241–1248PubMedGoogle Scholar
  61. 60.
    Osborne MJ, Stansby G (1991) Colon perforation during colonoscopy: surgical versus conservative management. Br J Surg 78:1402PubMedCrossRefGoogle Scholar
  62. 61.
    Park SI, Genta RS, Romeo DP et al. (1991) Colonic abscess and focal peritonitis secondary to India ink tattooing of the colon. Gastrointest Endosc 37:68–71PubMedCrossRefGoogle Scholar
  63. 62.
    Picciano LD, Hansel BC, Luchette FA (1995) Insufflation. Complications and recommendations. Surg Endosc 9(7):834–837PubMedCrossRefGoogle Scholar
  64. 63.
    Raijman I, Siemens M, Macron N (1995) Use of an expandable Ultraflex stent in the treatment of malignant rectal stricture. Endoscopy 27:273–276PubMedCrossRefGoogle Scholar
  65. 64.
    Ransohoff DF, Lang CA et al (1991) Colonoscopic surveillance after polypectomy: considerations of cost effectiveness. Ann Intern Med 114:177–182PubMedCrossRefGoogle Scholar
  66. 65.
    Rey JF, Romanczyk T, Greff M (1995) Metal stents for palliation of rectal carcinoma: a preliminary report on 12 patients. Endoscopy 27:501–504PubMedCrossRefGoogle Scholar
  67. 66.
    Rozen P, Somjen GJ, Baratz M et al (1994) Endoscope-in-duced colitis: description of probable cause by glutaralde-hyde, and prevention. Gastrointest Endosc 409(5):547–553CrossRefGoogle Scholar
  68. 67.
    Salmon P, Shah R, Berg SR, Williams CB (1994) Evaluating customer satisfaction with colonoscopy. Endoscopy 26(4):342PubMedCrossRefGoogle Scholar
  69. 68.
    Schoeffel U, Jaeger D, Pelz K et al (1994) Effect of human bowel wall distension on translocation of indigenous bacteria and endotoxins. Dig Dis Sci 39(3):490–493PubMedCrossRefGoogle Scholar
  70. 69.
    Seow-Choen F, Leong AF, Tsang C (1994) Selective sedation for colonoscopy. Gastrointest Endosc 40(6):661–664PubMedGoogle Scholar
  71. 70.
    Seow-Choen F, Look MC, Ho YH (1995) Non-surgical management of colonoscopic bowel perforation. Int J Colorectal Dis 10(2):77–78PubMedCrossRefGoogle Scholar
  72. 71.
    Shiffman ML, Farrell MT, Yee YS (1994) Risk of bleeding after endoscopic biopsy or polypectomy in patients taking aspirin or other NSAIDs. Gastrointest Endosc 40(4):458–462PubMedCrossRefGoogle Scholar
  73. 72.
    Shirai M, Nakamura T, Matsuura A et al (1994) Safer colonoscopic polypectomy with local submucosal injection of hypertonic saline-epinephrine solution. Am J Gastroenterol 89(3):334–338PubMedGoogle Scholar
  74. 73.
    Singaram C, Torbey CF, Jacoby RF (1995) Delayed post-polypectomy bleeding. Am J Gastroenterol 90(1):146–147PubMedGoogle Scholar
  75. 74.
    Standards Task Force: American Society of Colon and Rectal Surgeons (1992) Practice parameters for antibiotic prophylaxis supporting documentation. Dis Colon Rectum 35(3):277–285CrossRefGoogle Scholar
  76. 75.
    Stephenson KR, Rodriguez-Bigas MA (1994) Decompression of the large intestine in Ogilvies syndrome by a colonoscopically placed long intestinal tube. Surg Endosc 8:116–117PubMedCrossRefGoogle Scholar
  77. 76.
    Thornton JR, Losowsky MS (1991) Septicaemia after colonoscopy in patients with cirrhosis. Gut 32:450–451PubMedCrossRefGoogle Scholar
  78. 77.
    Vanner SJ, Mac Donald PH, Paterson WG et al (1990) A randomized prospective trial comparing oral sodium phosphate with standard polyethylene glycol-based lavage solution (Golytely) in the preparation of patients for colonoscopy. Am J Gastroenterol 85:422PubMedGoogle Scholar
  79. 78.
    Vincent M, Smith LE (1983) Management of perforation due to colonoscopy. Dis Colon Rectum 26:61–63PubMedCrossRefGoogle Scholar
  80. 79.
    Virgilio C, Cosentino S, Favara C, Russo V, Russo A (1995) Endoscopic treatment of postoperative colonic strictures using an achalsia dilator: short-term and long-term results. Endoscopy 27:219–222PubMedCrossRefGoogle Scholar
  81. 80.
    Waye JD, Lewis BS, Yessayan S (1992) Colonoscopy: a prospective report of complications. J Clin Gastroenterol 15(4):347–351PubMedCrossRefGoogle Scholar
  82. 81.
    Williams CB (1994) Comfort and quality in colonoscopy. Gastrointest Endosc 40(6):769–770PubMedGoogle Scholar
  83. 82.
    Zuccaro G, Fisher A, ASGE Standards of Practice Committee (1995) Compliance with practice guidelines for prophylactic antibiotics for endoscopic procedures. Gastrointest Endosc 41:33 ACrossRefGoogle Scholar
  84. 83.
    Zuckerman GR (1996) An ounce of prevention. Toward preventing gastrointestinal endoscopic complications. Gastrointest Endosc Clin N Am 6 (2):265–275PubMedGoogle Scholar
  85. 84.
    Zwas FR, Nicholas WC, El-Serag HB et al (1996) Colonic mucosal abnormalities associated with oral sodium phosphate solution. Gastrointest Endosc 43:46CrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • P. H. Wiesel
  • J. Hess
  • G. Dorta

There are no affiliations available

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