45332 Sigmoidoscopy, flexible; with removal of foreign body(s)

Name of the Procedure:

Sigmoidoscopy, flexible; with removal of foreign body(s).
Common Name(s): Flexible Sigmoidoscopy with Foreign Body Removal

Summary

A flexible sigmoidoscopy with foreign body removal is a medical procedure that uses a thin, flexible tube with a camera to examine the lower part of the large intestine (sigmoid colon) and rectum. This procedure not only helps in visualizing the colon but also allows for the removal of any foreign bodies that may be present.

Purpose

The purpose of this procedure is to locate and remove objects that have inadvertently entered the lower colon and rectum. It also helps diagnose and sometimes treat symptoms such as abdominal pain, bleeding, or constipation that might be caused by the foreign body.

Indications

• Presence of foreign body in the rectum or lower colon
• Abdominal pain or discomfort
• Rectal bleeding or abnormal discharge
• Chronic constipation or obstruction symptoms
• Any suspicion of ingestion or insertion of foreign objects

Preparation

• Fasting for several hours before the procedure is usually required.
• Patients may need to cleanse their bowels using a laxative or an enema the night before.
• Instructions will typically include avoiding certain medications or adjusting doses, especially blood thinners.
• Pre-procedural diagnostic tests might include blood work and imaging studies to locate the foreign body.

Procedure Description

1. The patient is asked to lie on their side on the examination table.
2. Sedation or local anesthesia may be administered to minimize discomfort.
3. A lubricated sigmoidoscope (a flexible tube with a camera) is gently inserted into the rectum.
4. The physician navigates the scope through the sigmoid colon to locate the foreign body.
5. Special tools can be passed through the scope to grasp and remove the foreign object.
6. The scope is then slowly withdrawn, and the area is examined for any additional issues or injuries.

Duration

The procedure typically takes about 15 to 30 minutes, though preparation and recovery could extend the total visit time.

Setting

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

Personnel

• Gastroenterologist or Surgeon
• Nursing staff
• Anesthesiologist or Nurse Anesthetist (if sedation or anesthesia is used)

Risks and Complications

• Perforation of the colon or rectum
• Bleeding
• Infection
• Adverse reaction to sedation or anesthesia
• Persistence of foreign body if not successfully removed

Benefits

• Safe removal of foreign objects without the need for major surgery
• Relieving symptoms caused by the foreign body
• Diagnosing other potential colon issues
• Immediate or short-term relief from discomfort

Recovery

• Post-procedure monitoring for a short time to ensure there are no immediate complications.
• Specific post-procedure care instructions such as dietary restrictions and activity limitations.
• Most patients can resume normal activities within a few days.
• Follow-up appointments may be needed to ensure full recovery and address any complications.

Alternatives

• Manual removal through the anus without endoscopy
• Surgical intervention if the foreign object is deeply embedded or if there are complications
• Non-invasive observation if the object may pass naturally, though this is less common

Patient Experience

During the procedure, patients may feel pressure or slight discomfort but sedation often minimizes this. After the procedure, patients may experience mild bloating or cramping, and any pain is typically well managed with prescribed pain relievers.