The role of colonoscopy in the management of intestinal obstruction: a 20-year retrospective study

Abstract

PurposeThe aim of the study was to assess the use colonoscopy over time in the assessment of large bowel obstruction in a tertiary university hospital.MethodsRetrospective analysis of surgical and colonoscopy records for the years 1990-2009 in a university hospital. All patients diagnosed with non-conservatively managed bowel obstruction were included.ResultsWe recorded 644 patients diagnosed with non-conservatively managed bowel obstruction. Four hundred forty-one (67.3%) were managed only by surgery, 157 (23.6%) were managed by colonoscopy, and 46 (6.9%) by combined colonoscopy and surgery. Patients over 77 years were more likely to receive colonoscopy as monotherapy or combined with surgery as compared to younger patients. Management by colonoscopy only and by combined colonoscopy and surgery increased over time.ConclusionsColonoscopy in the management of non-conservatively treated bowel obstruction increased over time. However, therapeutic colonoscopy still has a limited role in bowel obstruction either as monotherapy or combined with surgery.

Obstructing Sigmoid Volvulus: An Unusual Complication in a Pediatric Patient With Ulcerative Colitis

“…12,13 In a nontoxic patient with colonic dilation, colonoscopy may aid in the diagnosis of volvulus before surgery, especially in patients with IBD. 14 Volvulus was discovered in our patient at colonoscopy with a typical whirl sign (converging mucosa) at the rectosigmoid junction with immediate passage of gas on traversing this transition point. 8 The examination demonstrated very pale colonic mucosa extending to the splenic flexure, suggesting decreased perfusion of this segment of the colon.…”

Observational study of colonoscopy techniques used for acute colorectal obstruction: A single-center experience

“…The main reason for technical failure of stenting is the inability to pass through the stenosis with a guidewire or the deployment system due to the severity of the obstruction or its angularity ( 8 , 15 ). It has been suggested that SEMS should be placed by an experienced gastroenterologist, such as one who has independently placed at least 10–20 stents ( 7 – 9 , 24 ). In our Institution, four skilled operators meet that standard for performing SEMS, including an ERCP-specialized endoscopist.…”

Surgical Problems of the Digestive System

“…MRI also has both high sensitivity (95%) and specificity (100%) for SBO and LBO [54]. Colonoscopy is useful in confirming the diagnosis of LBO when in doubt, obtaining biopsies of obstructing lesions, derotating sigmoid volvulus, decompressing pseudo-obstruction, stenting strictures, and avoiding unnecessary surgery [55] .…”