45307 Proctosigmoidoscopy, rigid; with removal of foreign body

Name of the Procedure:

Proctosigmoidoscopy, rigid; with removal of foreign body
Common name(s): Rigid Proctosigmoidoscopy, Sigmoidoscopy with foreign body removal

Summary

A proctosigmoidoscopy is a medical procedure that uses a hollow, rigid tube to examine the rectum and the lower part of the colon (the sigmoid colon). This procedure also involves removing any foreign objects that may be lodged in these areas.

Purpose

This procedure addresses the presence of foreign objects in the rectum or sigmoid colon. The goals are to visualize the area, assess for any additional problems, and safely remove the foreign body to prevent complications like infection or obstruction.

Indications

• Presence of a foreign object in the rectum or sigmoid colon
• Symptoms such as pain, bleeding, or obstruction due to a foreign body
• Difficulty in passing stool linked to an obstruction by a foreign object

Preparation

• Patients may need to fast starting a few hours before the procedure.
• A bowel prep, such as an enema or laxative, may be required to clear the bowel.
• Patients should inform their doctor about any medications they are taking; some medications might need to be paused.
• Diagnostic imaging, like an X-ray or CT scan, may be done beforehand to locate the foreign object.

Procedure Description

1. The patient is positioned, usually lying on the side with knees drawn up to the chest.
2. Anesthesia or sedation may be administered if needed for comfort.
3. A rigid proctosigmoidoscope is gently inserted into the rectum and advanced into the sigmoid colon.
4. The healthcare provider visualizes the area through the scope and identifies the foreign body.
5. Specialized instruments are used through the scope to grasp and remove the foreign object.
6. The scope is then carefully withdrawn, and the area is assessed for any injury or other abnormalities.

Duration

The procedure typically takes about 15 to 30 minutes, depending on the complexity of the foreign body removal.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

The procedure involves a gastroenterologist or surgeon, supported by nursing staff. An anesthesiologist may be present if sedation or anesthesia is used.

Risks and Complications

• Mild discomfort or pain
• Bleeding or infection
• Perforation of the rectum or colon (rare but serious)
• Reaction to anesthesia or sedation

Benefits

• Relief from symptoms caused by the foreign body
• Prevention of complications like infection or bowel obstruction
• Rapid recovery from the removal of the foreign object

Recovery

• Patients may observe mild discomfort or bloating post-procedure.
• Pain relief medications might be recommended.
• Most patients can resume regular activities within 1-2 days.
• Follow-up appointment may be scheduled to ensure no further issues.

Alternatives

• Observation and natural passage of the foreign body (if small and not causing severe symptoms)
• Endoscopic retrieval using a flexible sigmoidoscope or colonoscope
• Surgery, in severe cases where endoscopic removal isn’t possible

Patient Experience

The patient might feel some pressure or mild discomfort during the insertion and manipulation of the scope. Sedation or anesthesia helps manage pain and discomfort during the procedure. Post-procedure, patients usually experience minimal discomfort and can typically return to normal activities shortly.