Use of a push enteroscope improves ability to perform total colonoscopy in previously unsuccessful attempts at colonoscopy in adult patients.

OBJECTIVE

Total colonoscopy with use of a standard adult colonoscope can be difficult in the presence of a redundant or angulated colon. It is often possible to traverse these areas with the use of a thinner, more flexible endoscope. The objective of this study was to evaluate the efficacy of completing total colonoscopy using a push enteroscope when a standard colonoscope was unsuccessful.

METHODS

A prospective analysis was performed for 721 consecutive colonoscopies attempted by two gastroenterologists. Those patients in whom complete colonoscopy was unsuccessful using the standard colonoscope (Olympus CF-100L) had attempts to complete colonoscopy using the enteroscope (Olympus SIF-100). The extent of each exam was recorded. Additional pathologic findings discovered by the use of the enteroscope and therapeutic interventions performed were additionally noted.

RESULTS

Colonoscopy using an enteroscope was performed in 32 patients with successful total colonoscopy in 22 patients (68.7%). Additional pathology was noted in nine patients who had successful complete colonoscopy using the enteroscope; adenomatous polyp (n = 5), adenocarcinoma (n = 1), bleeding source (n = 2), and extent of colitis (n = 1). Total colonoscopy rate using standard adult colonoscope was 93.2% (630 of 676) when cases with poor bowel preparation (n = 23) and obstructing lesions (n = 14) were excluded. When the results of successful colonoscopies with the enteroscope were included, the overall completion rate of total colonoscopy improved to 96.4% (652 of 676).

CONCLUSION

The use of the enteroscope to help evaluate patients who have had incomplete colonoscopies with the standard colonoscope increases the diagnostic yield of colonic examination.