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Related Concept Videos

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Endoscopic Procedures II: Colonoscopy01:25

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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Sigmoid volvulus management, only endoscopic devolvulation?

Marta García Calonge1, Daniel Muíño-Domínguez2, María Helena González Sánchez2

  • 1Aparato Digestivo, Hospital Universitario Central de Asturias, Spain.

Revista Espanola De Enfermedades Digestivas
|February 13, 2023
PubMed
Summary
This summary is machine-generated.

Sigmoid volvulus (SV) can lead to intestinal obstruction. Early endoscopic reduction is common, but recurrent cases with ischemia necessitate urgent surgery like sigmoidectomy for definitive treatment.

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Area of Science:

  • Gastroenterology
  • Abdominal Surgery
  • Emergency Medicine

Background:

  • Sigmoid volvulus (SV) is a significant cause of intestinal obstruction in emergency settings.
  • Treatment typically involves endoscopic devolvulation (ED) followed by elective surgery.
  • Recurrent SV poses challenges, with high recurrence rates after ED.

Observation:

  • A 78-year-old male with dementia presented with symptoms of intestinal obstruction.
  • Abdominal X-ray revealed the characteristic 'coffee bean' sign of SV.
  • The patient had a history of three previous successful ED treatments for recurrent SV.

Findings:

  • Urgent colonoscopy revealed 20 cm of ischemic, purplish-black sigmoid mucosa.
  • Histological examination of the resected specimen showed necrosis, ulceration, and inflammation.
  • The patient underwent successful sigmoidectomy and Hartmann colostomy.

Implications:

  • Recurrence of SV after ED is common (up to 86%), increasing risks of ischemia and perforation.
  • Early recognition of ischemia is crucial for timely surgical intervention.
  • Surgical sigmoidectomy with anastomosis is the recommended definitive treatment for recurrent or complicated SV.