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Factors that predict incomplete colonoscopy

W C Cirocco1, L C Rusin

  • 1Department of Colon and Rectal Surgery, Saint Vincent Health Center/Hamot Medical Center, Erie, Pennsylvania, USA.

Diseases of the Colon and Rectum
|September 1, 1995
PubMed
Summary

Women, particularly those with prior abdominal hysterectomy, face lower success rates for cecal intubation during colonoscopy due to impassable sigmoid colon. Previous colonoscopy completion does not predict future outcomes.

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Area of Science:

  • Gastroenterology
  • Endoscopy

Background:

  • Cecal intubation is a key indicator of colonoscopy quality.
  • Factors like prior abdominal surgery and diverticular disease may impede colonoscopy completion.

Purpose of the Study:

  • To prospectively evaluate the clinical relevance of patient history factors in hindering cecal intubation during colonoscopy.

Main Methods:

  • 1,047 consecutive colonoscopies were analyzed over 16 months.
  • Patient history, including prior abdominal surgery and diverticulitis, was assessed.
  • Cecal intubation rates were compared between demographic and clinical groups.

Main Results:

  • 9% of patients (90 total) had incomplete colonoscopies.
  • Women had significantly lower cecal intubation rates (66%) compared to men (34%).
  • Women with a history of abdominal hysterectomy showed a significantly lower cecal intubation rate (P < 0.01).
  • Diverticulitis history did not impact intubation rates.
  • Incomplete intubations in women often stopped at the sigmoid colon, while in men, it reached the right colon.

Conclusions:

  • Women, especially post-abdominal hysterectomy, experience lower cecal intubation rates, often due to sigmoid colon anatomy.
  • A prior failed colonoscopy does not necessarily predict future inability to reach the cecum.

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