Publication details
CT kolografie
| Title in English | CT colonography |
|---|---|
| Authors | |
| Year of publication | 2015 |
| Type | Chapter of a book |
| MU Faculty or unit | |
| Citation | |
| Description | Colonoscopy is the gold standard for imaging the colon and terminal ileum. Currently it plays essential role in the diagnosis and monitoring of neoplasms of the colon and also becomes the method of choice in the treatment of early neoplastic lesions. Colonoscopy also has a key role in the diagnosis of other colorectal disorders. Indication to colonoscopy can be classified into preventive in patients at average risk for colorectal cancer, dispensary at increased risk, and examinational in symptomatic patients with suspected bowel disease. An essential part of the examination is to prepare the patient, which includes not only good cleansing of the bowel, but also in instructing the patient, signing the informed consent, in antibiotic prophylaxis for selected patients and in the management of antithrombotic therapy. To perform the examination, it is necessary to know the assembling and function of the colonoscope, the arrangement of the operating theatre, problems of analgosedation, correct principles of inserting and removing colonoscope, records from examination, disinfection and sterilisation of colonoscope. Serious complications of colonoscopy are not frequent, but their awareness is crucial in the prevention, early detection and treatment. Techniques of alternative imaging, such as classical and virtual chromocolonoscopy, could in some situations increase the diagnostic yield of colonoscopy. A standard part of modern colonoscopy represents therapeutic intervention. Common is a forceps biopsy and endoscopic polypectomy; however colonoscopist should be familiar with the less conventional modalities such as endoscopic mucosal resection, endoscopic submucosal dissection, endoscopic hemostasis, dilation of stenoses, stenting ablation techniques and tattoo. Optimal administration of colonoscopy should be verified by regularly monitoring quality parameters. Development of alternative techniques in colonoscopy is motivated mainly by the discomfort associated with the examination and by unsatisfactory detection of neoplastic lesions. As most promising, the water-assisted colonoscopy and insuflation with carbon dioxide are considered. Colonoscopy can vary in special situations such as idiopathic inflammatory bowel disease, in paediatric patients, during pregnancy and lactation, in patients with a stomy and cardiac implants. Besides colonoscopy, colon can be examined by alternative techniques, including capsule colonoscopy, irrigography, CT colonography, sonography and by some laboratory methods. |