Colonic polyps retrieval after endoscopic resection

COLON AND R E C T U M

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RELATIONSHIP B~rwEEN RECrOSI6HOID POLYPS AND PI~JKI~4ALCOLONIC NEOPLASNS: CHI~{OgNDOSCOPIC ST{JOY IN ASY~TO~TIC PATI~4TS, H. Mitooka, H.Matsuo, K. Irie, T. Fujimori, S. ~aeda. ~ e i Hospital and 2nd Bepts. of Pathology, Kobe University School of ~edieine, Kobe, Japan. There is l i t t l e doubt t h a t endoscopic sprays and dyes (chromoscopy) held demonstrate mucosal i r r e f q l l a r i t i e s and detect small colonic lesions. To determine the significance of rectoslgmoid polyp, we retrospectively reviewed colonoscopy reports of the asymptomatic patients who were examined by contrast chromnseopy using indigo carmine eapanle(CCIC) (Gastrointest Endosc 1992;38: 373 4). To our knowledge, the c o r r e l a t i o n of d i s t a l and proximal eolorectal lesions has not been studied by chromoscopy. P a t i e n t s and method: Between Jun. 1990 and Dec. 1993, a l l patients undergoing colonoscopy with CCIC were entered. 0f these, 302 p a t i e n t s f u l f i l l e d the following conditions: complete total colonoscopy for screening (without h i s t o l y of colorectal polyps or cancer, perianal bleeding, occult blood, abdominal pain or a recent change in bowel habit). The location, size & histopathology of each polyp removed were studied. The patients were divided into four groups based on the findings in the rectosigm Did colon. There are no s i g n i f i c a n t differences in the sex and age (mean age 55.7y) d i s t r i b u t i o n of these groups. Result: Rectosigmoid Patients Proximal Neoplasm polyps N N

ILEOSCOPY IN THE DIFFERENTIAL D I A G N O S I S OF INFLAMMATORY BOWEL DISEASE ( I B D ) . M. Mu~oz-Navas M.T. Betes, C. Corolla, J.C. Subtil, R. Angos, E. Macias. E n d o s c o p y Unit.'University Clinic of Navarra. Pamplona. spain. Differential diagnosis in IBD is a con~non clinical problem. The high risk of c o m p l i c a t i o n s in p e r f o r m i n g total colonoscopy is also frequently reported. From January 1992 to october 1994 ileoscopies were performed on suspected IBD patients in order to test the diagnostic value of the procedure and evaluate the increase in exploration time, e n d o s c o p y and biopsy data and morbidity risk. From 5614 colonoscopies, IBD was diagnosed in 222 patients (pts) and tezTainal ileum {T.I.) was explored in 185 of t h e m (83.3%). Ileoscopy was not possible due to ileocecal valve stenosis (19 pts), colon stenosis (4 pts), technical p r o b l e m s (7 pts), bad tolerance (2 pts), deficient bowel p r e p a r a t i o n (2 pts) and severe colonic disease (2 pes). We could obtain ileum biopsies in i0 out of 37 pts without ileoscopy~ The average time to reach the cecum was 7 m i n u t e s and 30 seconds, 2 min 30 sac more were spent to explore the T~I. From 91 pts with Crohn's disease, ileoscopy was p e r f o r m e d in 65 (macroscopic lesions in 54). Biopsy specimens from ileum were obtained in 72 pts (histologic lesions in 55). Ileal lesions were essential to e s t a b l i s h the diagnosis of Crohn's disease in 31 pts. Out of them, 2 4 c a s e s did not present colonic disease and 4 h a d h i s t o l o g i c l e s i o n s with normal appearance of T.I. at endoscopy. Accurate diagnosis could not be established upon endoscopic and/or histologic examination in ii cases. Without ileoscopy, a number significantly less of p a t i e n t s w o u l d have been diagnosed of Crohn's disease (p