[Emergency colonoscopy in lower intestinal occlusion]

From March 1980 to June 1983, 23 patients presenting with clinical and or radiological manifestations of colonic obstruction and with uncertainty as to medical/surgical possibilities of management, underwent emergency colonoscopy in the intensive care unit of our Digestive Disease Department. The investigations were conducted without preparation (enema) or premedication, using an ordinary colonoscope. The endoscopic examination led to correct diagnosis in 21 patients out of 23 (91.3 p. 100). The main causes of occlusion were: colonic or rectal cancer (11 cases), Ogilvie's syndrome (6 cases), volvulus of the sigmoid colon (3 cases). Endoscopy contributed to treatment in eight patients with good results in six. It was unsatisfactory in two cases of volvulus of the sigmoid colon which recurred. In two instances complications occurred which were attributable to the method: one pneumoperitoneum without frank perforation and a transtumoral perforation in a case of sigmoid cancer, discovered at laparotomy. No septic complication or mortality resulted from endoscopy. Colonoscopy under normal conditions should not be advocated systematically, but can be used as a method of investigation and possibly of therapy in selected cases of colonic obstruction admitted into intensive care units.