45379 Colonoscopy, flexible; with removal of foreign body(s)

Name of the Procedure:

Colonoscopy, flexible; with removal of foreign body(s)

• Common names: Colonoscopy with foreign body removal, Flexible colonoscopy.

Summary

A flexible colonoscopy with removal of foreign body(s) involves using a long, thin, flexible tube called a colonoscope, which is equipped with a light and camera. This allows the doctor to view the inside of the colon and rectum. If any foreign bodies are found, they can be safely removed during the same procedure.

Purpose

• Medical condition/problem addressed: This procedure is aimed at finding and removing foreign objects that may have been accidentally ingested or otherwise inserted into the colon or rectum.
• Goals and expected outcomes: The goal is to safely remove the foreign object to prevent complications like infection, obstruction, or perforation of the colon, and to restore normal function.

Indications

• Specific symptoms/conditions: Unexplained abdominal pain, rectal bleeding, obstruction signs, or known ingestion/insertion of an object.
• Patient criteria: Patients who have symptoms suggesting the presence of a foreign body in the colon or rectum, or those with known ingestion/insertion events.

Preparation

• Pre-procedure instructions: Patients usually need to follow a clear-liquid diet for 24 hours before the procedure and undergo bowel preparation, which may involve taking a laxative solution and/or enema to cleanse the colon.
• Diagnostic tests/assessments: Routine blood tests, an abdominal X-ray or CT scan may be required to locate the foreign body before the procedure.

Procedure Description

1. Sedation: The patient is given sedatives or anesthesia to ensure comfort.
2. Insertion: A colonoscope is gently inserted through the anus and guided through the rectum and colon.
3. Visualization: The camera on the colonoscope transmits images to a monitor, allowing the doctor to carefully examine the intestinal lining.
4. Removal of foreign body: Special tools passed through the colonoscope enable the doctor to grasp and remove the foreign body.
5. Completion: The colonoscope is slowly withdrawn while the doctor ensures there are no complications.

• Tools/Equipment: Colonoscope, grasping forceps, retrieval baskets, and snares.
• Anesthesia/Sedation: Usually, intravenous sedatives and analgesics; in some cases, general anesthesia.

Duration

The procedure typically takes between 30 to 60 minutes, depending on whether any complications arise or the difficulty in removing the foreign body.

Setting

The procedure is performed in a hospital, outpatient clinic, or surgical center, often in an endoscopy suite.

Personnel

• Gastroenterologist or surgeon
• Anesthesiologist or nurse anesthetist
• Nursing staff

Risks and Complications

• Common risks: Discomfort, bloating, minor bleeding at the removal site.
• Rare risks: Perforation of the colon, infection, significant bleeding, adverse reaction to sedation.

Benefits

• Expected benefits: Immediate removal of the foreign body, relief of symptoms, and prevention of potential complications.
• How soon: Benefits are typically realized immediately or within a few days post-procedure.

Recovery

• Post-procedure care: Monitoring in a recovery area until the effects of sedation wear off. Instructions on dietary restrictions and activity limitations for a short period post-procedure.
• Recovery time: Most patients can return to normal activities within 24 to 48 hours. Follow-up appointments may be scheduled to ensure complete recovery.

Alternatives

• Other treatment options: Watchful waiting in cases of small, passable objects; use of laxatives to expedite natural passage; surgical removal for objects that cannot be retrieved endoscopically.
• Pros and cons: Non-invasive compared to surgery, quicker recovery. Surgery might be required for large or complex cases.

Patient Experience

• During the procedure: Little to no discomfort due to sedation. Occasional feelings of pressure or bloating.
• Post-procedure: Mild cramping or bloating may occur, but pain management will be provided. Most patients experience quick and full recovery with minimal discomfort.