Hayat, M.; Mcrae, C.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA113
Academic Journal
Introduction: Patients referred to the rectal bleeding clinic (RBC) for open access flexible sigmoidoscopy (FS) may require further investigations. Aims: To look at the diagnostic yield of colonoscopy following FS. Results: Between 1/12/99 to 30/11/2001, 318 patients attending the RBC had further investigations requested (268 colonoscopies, 44 barium studies, 5 repeat F/S, 1 abdominal USS). Of the 268 colonoscopies requested 211 were performed. In those patients who had colonoscopy the indications for the FS referral were: rectal bleeding (n = 168), altered bowel habits (n = 36), abdominal pain (n = 7). The indications for performing colonoscopy in these patients were: further evaluation of rectal bleeding (n = 41), change in bowel habit (n = 64), abdominal pain (n = 9), polyps on FS (n = 84), weight loss (n = 2), colorectal cancer found at FS (n = 2), inflammatory bowel disease found at FS (n = 8) and anaemia (n = 1). Additional findings at colonoscopy were divided into those that were within the limits of the previous FS examination as stated on the FS report, and those beyond the reach of the previous examination, ie if the FS report stated that the instrument had been passed to the descending colon then a lesion found subsequently in the sigmoid at colonoscopy would be counted as a "left-sided lesion". Conclusions: A substantial number of patients attending for open access FS warranted full colonoscopy as the initial investigation of choice, suggesting a need to improve the screening of referrals.The diagnostic yield of additional significant lesions found at colonoscopy was high. However, almost all of these lesions were found within the reach of FS.


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