Use of a pediatric colonoscope improves the success of total colonoscopy in selected adult patients.

Abstract

BACKGROUND:

Colonoscopy using a standard adult colonoscope can be difficult or impossible when there is a fixed, angulated sigmoid colon or stricture. It is sometimes possible to traverse such segments using a smaller-diameter, more flexible pediatric colonoscope.

METHODS:

For this prospective study, one endoscopist started 645 consecutive, elective colonoscopies with a standard adult Olympus CF-100L colonoscope (52% women, 48% men). There were 36 examinations (5.6%) in which the adult colonoscope could not be passed through a fixed, angulated sigmoid colon (n = 34) or a sigmoid colonic stricture (n = 2). In such instances (33 women and 3 men), the endoscopist switched to a pediatric colonoscope.

RESULTS:

The pediatric colonoscope successfully reached the cecum in 21 of the 36 cases (58.3%). The figure was 38.5% for the older Olympus CF-P20L fiberoptic colonoscope (n = 13) and 69.6% for the newer Olympus PCF-100 videocolonoscope (n = 23). Concomitant conditions in the 34 patients in whom the pediatric colonoscope was used because of a fixed, angulated sigmoid included previous pelvic surgery in 22, pelvic radiation therapy in 2, pelvic endometriosis in 3, and two with previous sigmoid diverticulitis.

CONCLUSIONS:

The pediatric colonoscope, and particularly the newer Olympus PCF-100 colonoscope, is very useful in adult patients in whom it is not possible to traverse a fixed, angulated sigmoid colon or stricture using the standard adult colonoscope. This is predominantly a problem of female patients. Previous pelvic surgery may be an important causative factor in this regard.

• Authors: J B Marshall
• Journal: Gastrointestinal endoscopy (Gastrointest Endosc) Vol. 44 Issue 6 Pg. 675-8 (Dec 1996) ISSN: 0016-5107 [Print] United States
• PMID: 8979056 (Publication Type: Journal Article)

Topics

• Colon (pathology)
• Colon, Sigmoid (pathology)
• Colonic Diseases (diagnosis)
• Colonoscopes
• Constriction, Pathologic (diagnosis)
• Female
• Humans
• Male
• Middle Aged
• Prospective Studies
• Sigmoid Diseases (diagnosis)
• Sigmoidoscopes