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Right colon loop: a potential pitfall for total colonoscopy

J B Rhodes, J Zvargulis, R Moffat

    Endoscopy
    |November 1, 1978
    PubMed
    Summary
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    A right colon loop can occur during total colonoscopy, potentially leading to missed cecal cancers. This condition arises from embryological arrest and overdistension, and can be identified using imaging techniques.

    Area of Science:

    • Gastroenterology
    • Endoscopy
    • Colorectal Surgery

    Background:

    • Total colonoscopy is a key diagnostic procedure for colorectal cancer screening.
    • Identifying the cecum is crucial for confirming complete colonoscopy.
    • Anatomical variations can complicate endoscopic procedures.

    Observation:

    • A right colon loop, an unusual configuration of the colon, can occur during colonoscopy.
    • A visible light on the anterior abdominal wall in the right lower quadrant suggests the colonoscope tip may be in the cecum.
    • Fluoroscopic views can aid in assessing the colonoscope's position.

    Findings:

    • Right colon loops can be definitively documented using roentgenograms (X-rays) and radio-opaque contrast injections.
    • The embryological basis for a right colon loop involves an arrest in development coupled with excessive air insufflation.

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  • Failure to recognize this loop can result in a missed diagnosis of cecal carcinoma.

    • Implications:

    • Accurate identification and documentation of right colon loops are essential for procedural success.
    • Awareness of this anatomical anomaly can prevent misinterpretation of the colonoscope's location.
    • Preventing missed cecal cancers relies on recognizing and navigating right colon loops effectively.