lower gastrointestinal endoscopy
Endoscopy of the lower digestive tract includes colonoscopy and enteroscopy, and because of the limited application of the latter, equipment and technical requirements are high, only colonoscopy is discussed here. In the ileocecal valve mouth, adjust the angle of the colonoscope apex as much as possible, insert or squeeze into the ileocecal valve, and observe the intestinal cavity and mucosa in the range of 15 to 30 cm in the distal ileum. Basic Information Specialist classification: Digestive examination classification: endoscope Applicable gender: whether men and women apply fasting: fasting Tips: Acute severe colitis, such as severe diarrhea, ulcerative colitis and diverticulitis, is not suitable for this examination. Normal value No abnormalities were observed in the intestinal lumen and mucosa. Clinical significance Abnormal results: Basic diseases of colon disease, such as inflammation, ulcers and tumors have similarities with upper gastrointestinal diseases. People who need to check: There are symptoms and signs such as diarrhea, blood in the stool, lower abdominal pain, anemia, abdominal mass, and the cause is unknown. Precautions Taboo before inspection: eating and drinking. Requirements for inspection: cooperate with the doctor. Inspection process (1) The patient wears a hole in the examination pants and takes the left lateral position, and the legs are flexed. (2) The surgeon first performs a digital rectal examination to find out whether there are tumors, stenosis, hemorrhoids, anal fissures, etc. The assistant applies the lubricant to the anterior end of the colonoscopy (usually silicone oil, liquid paraffin is not available), then the patient breathes, relaxes the anal sphincter, presses the lens with the right index finger, and slides the lens into the anus, then slows down according to the operator's instructions. Progressive mirror. (3) Follow the tunnel and follow the sliding direction, a small amount of gas injection, proper hooking, bending, straightening, anti-mite, antispasmodic and other methods of inserting mirrors slowly into the colonoscopy. Special attention should be paid to the shortening of the suction and the straightening of the sigmoid colon and the transverse colon. In the splenic and hepatic flexures, the hooks and mirrors are properly hooked, and the patient's breathing and posture are taken into the mirror to reduce the angle of the turning and shorten the distance of the examination. (4) The signs that reach the ileocecal area are crescent-shaped appendix holes, Y-shaped (draw-like) blind-tip folds and fish-like ileocecal valves, and some patients can still see whipworms. Light clusters concentrated in the lower right abdomen can be seen on the body surface. In the ileocecal valve mouth, adjust the angle of the colonoscope apex as much as possible, insert or squeeze into the ileocecal valve, and observe the intestinal cavity and mucosa in the range of 15 to 30 cm in the distal ileum. Not suitable for the crowd Inappropriate people: acute severe colitis, such as severe diarrhea, ulcerative colitis and diverticulitis. Adverse reactions and risks Blood in the stool: due to mucosal damage. When the amount of bleeding is small, it can stop itself; if there is too much bleeding, endoscopic hemostasis should be performed.
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