Internal Medicine

Atlas of coloscopy by Francesco Paolo Rossini M.D. (auth.)

By Francesco Paolo Rossini M.D. (auth.)

by Mario Banche, M.D. IX The neologism "coloscopy" (colonscopy, colonoscopy) is the most recent addition to the vocabulary of endoscopy of the big gut. simply because the time period "duodenoscopy" used to be in endoscopy of the higher digestive tract many years in the past. With the appearance of the coloscope it's now attainable to envision the massive bowel extra largely and successfully than used to be previously attainable with using its inflexible forerunner, the rectosigmoidoscope. The earliest rectoscopes, eleven endoscopes" brought throughout the nineteenth century by way of Segales and Desormeaux (1826, 1853), have been conceived for lots of uses-inspection of the urethra, bladder, uterus, rectum. Successive advancements finally resulted in the development of an software designed completely for endoscopy of the rectum and sigmoid colon (Bensaude, 1907). Over the subsequent years the rectoscope underwent no gigantic switch and hence an ample and homogeneous literature gathered within which the on hand tools and their use have been defined whereas the endoscopic pathologic nosography and corresponding endoscopic photographs of the rectum and sigmoid colon have been codified, illustrated first via uncomplicated sketches and later by means of nonetheless and movement images. The literature comprises many fantastic guides, a few in monograph form.

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32. The tip of the coloscope is impacted at the sigmoid-descending colon junction. Fig. 33. The coloscope is withdrawn into the first portion of the sigmoid colon to make rotation possible. 23 Fig. 34. The coloscope has been rotated counterclockwise. The sigmoid colon is displaced to the right. 24 Fig. 35. Fig. 36. Fig. 37. Fig. 38. Fig. 39. Fig. 40. ion of the coloscope along the large bowel The fibrecoloscope forms an alpha loop in the sigmoid colon and then descends into the pelvis towards the distal portion of the descending colon (Fig.

Fig. 28. Fig. 29. Fig. 30. Fig. 31. Progression of the coloscope in the sigmoid and descending colon The flexible coloscope passes through the rectosigmoid junction (Fig. 26) into the middle portion of the sigmoid colon (Fig. 27) to reach the sigmoid-descending colon junction where the tip becomes impacted (Fig. 28). The tip of the coloscope is then flexed to face the descending colon and the instrument is withdrawn and slightly rotated clockwise until it gains the descending colon (Fig. 29). The sigmoid colon is straightened out (Fig.

79. Descending colon and left flexure. The insufflation of a large volume of air has distended the bowel wall excessively and has altered the normal circular shape of the haustral folds and the endoscopic appearance of the mucosa. besides narrowing the splenic flexure. Fig. 80. General view of the transverse colon. Note the characteristic triangular folds. Routine illumination (150 W). Fig. 81. Same view with 300 W illumination. Fig. 82. Middle third of the transverse colon. 51 Fig. 83. First portion of the transverse colon.

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