Core Concepts in Colonoscopy

183 Pages·2014·3.41 MB·English

by  Douglas Adler

A EDITOR
d
CORE le Douglas G. Adler
r
INCLUDES
CONCEPTS
Video Website
CORE Access
in
CCOOLLOONNOOSSCCOOPPYY CONCEPTS
in
Core Concepts in Colonoscopy covers all aspects of diagnostic and therapeutic colonoscopy,
emphasizing overarching concepts that gastroenterology fellows and physicians must know CC CCOOLLOONNOOSSCCOOPPYY
OO
to achieve success in both the technical and cognitive aspects of the procedure. In this RR
comprehensive resource, Dr. Douglas G. Adler and his contributors provide a straightforward EE
C C
and practical review of colonoscopy.
OO
NN
Core Concepts in Colonoscopy aims to address and convey the core concepts of
CC
colonoscopy: from the structure and function of the colonoscope itself, to insertion techniques, EE
PP
loop formation and reduction, polypectomy techniques for any situation, the avoidance
TT
and management of perforations and other adverse events, as well as advanced techniques SS
ii
including (but not limited to) endoscopic mucosal resection and colonic stenting. nn
CC
Each chapter inside Core Concepts in Colonoscopy is lavishly illustrated with multiple OO
LL
key images to accentuate and enhance the written text, as well as a plethora of tips, tricks, and
OO
accumulated points of wisdom in each chapter on all facets of colonoscopy. NN
OO
SS
◊Additional Website Component! CC
OO
Core Concepts in Colonoscopy is accompanied by a video website with specific videos PP
connected to individual chapters that will illustrate basic and advanced colonoscopic techniques YY
from many leading experts and will further enhance the learning process. The addition of the
video website allows for a more robust learning experience; allows the reader to watch, listen, and
view repeatedly; and reinforces the techniques presented in the written text.
GI fellows, junior gastroenterologists, and even advanced physicians will appreciate Core
Concepts in Colonoscopy because of the user-friendly and efficient structure that allows
them to easily absorb the wealth of key practical knowledge found inside.
MEDICAL/Gastroenterology SLACKINCORPORATED SLACK Incorporated
CORE
CONCEPTS
in
COLONOSCOPY

CORE
CONCEPTS
in
COLONOSCOPY
Editor
Douglas G. Adler, MD, FACG, AGAF, FASGE
Associate Professor of Medicine
Director of Therapeutic Endoscopy
Gastroenterology and Hepatology
Huntsman Cancer Institute
University of Utah School of Medicine
Salt Lake City, Utah
www.Healio.com/books
Copyright © 2014 by SLACK Incorporated
All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in
any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without written
permission from the publisher, except for brief quotations embodied in critical articles and reviews.
The procedures and practices described in this publication should be implemented in a manner consistent
with the professional standards set for the circumstances that apply in each specific situation. Every effort
has been made to confirm the accuracy of the information presented and to correctly relate generally
accepted practices. The authors, editors, and publisher cannot accept responsibility for errors or exclusions or
for the outcome of the material presented herein. There is no expressed or implied warranty of this book or
information imparted by it. Care has been taken to ensure that drug selection and dosages are in accordance
with currently accepted/recommended practice. Off-label uses of drugs may be discussed. Due to continuing
research, changes in government policy and regulations, and various effects of drug reactions and interac-
tions, it is recommended that the reader carefully review all materials and literature provided for each drug,
especially those that are new or not frequently used. Some drugs or devices in this publication have clearance
for use in a restricted research setting by the Food and Drug and Administration or FDA. Each professional
should determine the FDA status of any drug or device prior to use in their practice.
Any review or mention of specific companies or products is not intended as an endorsement by the author
or publisher.
SLACK Incorporated uses a review process to evaluate submitted material. Prior to publication, educators or
clinicians provide important feedback on the content that we publish. We welcome feedback on this work.
Published by: SLACK Incorporated
6900 Grove Road
Thorofare, NJ 08086 USA
Telephone: [phone]
Fax: [phone]
www.Healio.com/books
Contact SLACK Incorporated for more information about other books in this field or about the availability
of our books from distributors outside the United States.
Library of Congress Cataloging-in-Publication Data
Core concepts in colonoscopy / [edited by] Douglas Adler.
p. ; cm.
Includes bibliographical references and index.
(alk. paper)
I. Adler, Douglas G., 1969- editor of compilation.
[DNLM: 1. Colonoscopy. WI 520]
RC804.C64
616.3’407545--dc23
2014004464
For permission to reprint material in another publication, contact SLACK Incorporated. Authorization to
photocopy items for internal, personal, or academic use is granted by SLACK Incorporated provided that the
appropriate fee is paid directly to Copyright Clearance Center. Prior to photocopying items, please contact
the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923 USA; phone: [phone];
website: www.copyright.com; email: [e-mail]

Please note that the purchase of this e-book comes with an associated website or DVD. If you are interested in
receiving a copy, please contact us at [e-mail].
D
EDICATION
For my wife and children.

C
ONTENTS
Dedication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
About the Editor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Contributing Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xv
Chapter 1 The Structure and Function of the Modern Colonoscope . . . . . . . . . . . . .1
John G. Lieb II, MD
Chapter 2 Enhanced Imaging Techniques: What They Can and Cannot Do and
When to Use Them . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
Norio Fukami, MD, AGAF, FACG, FASGE
Chapter 3 Air Versus Carbon Dioxide Insufflation Versus Water Immersion During
Colonoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
Douglas Pleskow, MD, AGAF, FASGE; Tolga Erim, DO;
and Gyanprakash Ketwaroo, MD
Chapter 4 External Pressure During Colonoscopy: How and When to Use It . . . .39
Nicolas Villa, MD and Waqar Qureshi, MD, FRCP
Chapter 5 Endoscopic Loops During Colonoscopy: How to Avoid Their Formation
and How to Reduce Them When They Arise . . . . . . . . . . . . . . . . . . . . . 51
Vivek Kaul, MD, FACG and Shivangi Kothari, MD
Chapter 6 Endoscopic Polypectomy Techniques: From Small to Large Lesions . . . 61
Ali Siddiqui, MD; Serag Dredar, MD; Anna Strongin, MD;
C. Andrew Kistler, MD, PharmD; and Shou-Jiang Tang, MD
Chapter 7 Postcolonoscopy Decision Making: The Guidelines and Beyond . . . . . .81
Melissa A. Verrengia, MD and Jeffrey L. Tokar, MD
Chapter 8 C olonoscopy Perforations: How to Avoid Them and What to Do if
They Happen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99
Louis M. Wong Kee Song, MD and Todd H. Baron, MD
Chapter 9 Colon Decompression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Robert E. Sedlack, MD, MHPE
Chapter 10 Colonic Stenting: What You Need to Know . . . . . . . . . . . . . . . . . . . . .127
Kathryn R. Byrne, MD and Douglas G. Adler, MD, FACG, AGAF, FASGE
Chapter 11 Lower Gastrointestinal Bleeding: How to Evaluate and Manage . . . . . 143
Linda S. Lee, MD and John R. Saltzman, MD, FACP, FACG, FASGE
Chapter 12 Colonoscopy Quality Indicators in Training and Beyond: What You
Need to Know . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Jonathan Cohen, MD, FASGE, FACG
Financial Disclosures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

A
CKNOWLEDGMENTS
I would like to thank Carrie Kotlar and John Bond for their support and enthusiasm
for this project at all phases of conception and development.