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Colonoscopy in critically ill patients. What conditions call for it?
M Southworth1, S L Taffet, D H Levien
1Department of Surgery, New Rochelle Hospital and Medical Center, NY 10802.
Postgraduate Medicine
|November 1, 1990
Summary
Colonoscopy in the intensive care unit is indicated for lower intestinal bleeding and other conditions. This procedure can be performed safely in critically ill patients, often without bowel preparation due to colonic dilatation.
Area of Science:
- Gastroenterology
- Critical Care Medicine
Background:
- Colonoscopy is an essential diagnostic tool in intensive care units (ICUs).
- Specific indications include acute lower intestinal bleeding, sigmoid volvulus, colonic pseudo-obstruction, and suspected pseudomembranous colitis.
Purpose of the Study:
- To outline the indications for performing colonoscopy in critically ill patients.
- To discuss the safety and feasibility of colonoscopy in the ICU setting.
Main Methods:
- Review of indications for colonoscopy in the ICU.
- Discussion of procedural considerations and potential complications.
- Highlighting the possibility of performing endoscopy without bowel preparation.
Main Results:
- Colonoscopy is indicated for acute lower intestinal bleeding, sigmoid volvulus, pseudo-obstruction, and suspected pseudomembranous colitis in ICUs.
- Cardiorespiratory complications may be more frequent in critically ill patients.
- Endoscopy can often be performed without bowel preparation due to colonic dilatation.
Conclusions:
- Colonoscopy can be safely performed in the intensive care unit with meticulous attention to detail.
- The absence of bowel preparation is often feasible due to colonic dilatation in these patients.