Name of the Procedure:

Sigmoidoscopy, flexible; with endoscopic ultrasound examination (Flexible Sigmoidoscopy with EUS).

Summary

A flexible sigmoidoscopy with endoscopic ultrasound is a medical procedure that combines two advanced techniques to examine the lower part of the large intestine (sigmoid colon) and nearby tissues using a flexible tube with a camera and an ultrasound probe.

Purpose

This procedure is primarily used to diagnose and stage diseases of the rectum, sigmoid colon, and surrounding tissues. It helps in evaluating conditions like tumors, polyps, and other abnormalities.

Indications

• Chronic diarrhea or constipation
• Rectal bleeding or blood in the stool
• Abdominal pain
• Suspected colorectal cancer
• Evaluation of previously detected polyps or tumors

Preparation

• Patients are typically instructed to follow a clear liquid diet 24 hours before the procedure.
• A bowel prep (laxative solution) is usually required to cleanse the colon.
• Patients may need to adjust their medications, especially if they are on blood thinners.

Procedure Description

1. The patient is positioned on their side on an examination table.
2. Sedation or anesthesia may be administered for comfort.
3. A flexible sigmoidoscope is gently inserted into the rectum.
4. The scope, equipped with a camera, visualizes the interior of the sigmoid colon.
5. An ultrasound probe at the tip of the scope emits sound waves to create detailed images of the bowel wall and nearby organs.
6. Any abnormalities detected can be biopsied or sampled during the procedure.

Duration

The procedure typically takes about 30-45 minutes.

Setting

It is usually performed in a hospital endoscopy unit or an outpatient clinic.

Personnel

• Gastroenterologist or colorectal surgeon
• Endoscopy nurses
• Anesthesiologist (if sedation or anesthesia is used)

Risks and Complications

• Bleeding
• Perforation of the colon
• Infection
• Adverse reaction to sedation
• Mild abdominal cramping

Benefits

• Accurate diagnosis of colorectal diseases
• Early detection and staging of colorectal cancer
• Ability to biopsy and sample tissues
• Minimally invasive with relatively quick recovery

Recovery

• Post-procedure observation for a short period.
• Patients can usually return home the same day.
• Instructions to rest and avoid heavy lifting for 24 hours.
• Follow-up appointments may be scheduled to discuss biopsy results.

Alternatives

• Colonoscopy: A more extensive examination of the entire colon; more invasive but provides a comprehensive view.
• CT colonography: A virtual colonoscopy using CT scans; non-invasive but less detailed.
• MRI: Useful for soft tissue imaging but not as effective for internal lining assessment.

Patient Experience

• Mild discomfort or bloating due to air introduced into the colon.
• Sedation helps minimize discomfort during the procedure.
• Post-procedure, patients may feel drowsy and will need someone to drive them home.
• Pain management usually involves over-the-counter pain relievers, if needed.