A prospective study on the diagnostic yield of lower gastrointestinal endoscopy for altered bowel habits, lower abdominal pain and rectal bleeding

Hemnath, U A (2014) A prospective study on the diagnostic yield of lower gastrointestinal endoscopy for altered bowel habits, lower abdominal pain and rectal bleeding. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Over the last two decades, there has been a remarkable advancement in gastrointestinal endoscopy, and lower gastrointestinal endoscopy (colonoscopy and sigmoidoscopy) has become the most commonly performed procedure for the diagnosis and treatment of diseases of the large intestine as well as screening for malignancy. The demand for lower GI endoscopy has been increasing over the years, given the relative safety and low complication rates.The diagnostic yield of an endoscopic procedure is defined as its capacity for identifying a lesion that is potentially important to patient care. AIM AND OBJECTIVES: 1. To evaluate the spectrum of clinical findings in lower gastrointestinal endoscopy in patients presenting with altered bowel habits, bleeding per rectum and abdominal pain and to evaluate its diagnostic yield. 2. To analyze the symptomatology in colorectal carcinoma. MATERIALS AND METHODOLOGY: The 100 patients presenting with lower GI symptoms such as bleeding p/r, lower abdominal pain and altered bowel habits are subjected to lower GI endoscopy. The findings in the colonoscopy or sigmoidoscopy are recorded. The diagnostic yield of the procedure for the particular indication is calculated. RESULTS: The diagnostic yield of lower GI endoscopy in our study is as high as 44%, whereas the complication rate of diagnostic endoscopy is almost nil except minor abdominal discomfort. The diagnostic yield for colorectal cancer is highest for patients presenting with multiple lower GI symptoms. Rectal bleed is the most common presenting symptom in colorectal malignancy. CONCLUSION: From this study we conclude that lower GI endoscopy is mandatory in patients presenting with multiple lower GI symptoms and bleeding per rectum; and screening with sigmoidoscopy should preferably be considered in patients presenting with common diseases of the anorectum. In patients presenting with low yield symptoms, judicious decision making is required to either subject the patient to endoscopy or other less invasive investigations.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Colonoscopy ; sigmoidoscopy ; diagnostic yield.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 05 Jul 2018 03:43
Last Modified: 05 Jul 2018 17:01
URI: http://repository-tnmgrmu.ac.in/id/eprint/8631

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