A 64 yrs female patient
was referred to Endoscopy Asia for the favor of Ileo-Colonoscopy to evaluate
the exact etiology of frank bleeding per rectum.
Endoscopy
Asia’s Intervention:
- Diagnosis: Since Patient gave history of two episodes in last 2 days, we considered her for the procedure after a thorough preparation. Ileo-colonoscopy revealed a small 3-4 mm classical Angiodysplastic lesion in the caecum close to the appendicular opening. The lesion was very well appreciated on NBI (narrow band imaging). Terminal ileum (15 cms) and rest of the colon appeared absolutely normal.
- Treatment: In view of the above findings, bipolar heater probe coagulation was performed and the lesion was completely fulgurated. Complete haemostasis was ensured and patient was sent home on OPD basis.
- Prognosis of the patient: The patient responded very well to the treatment.
Important
Note from Endoscopy Asia
It is our
protocol at Endoscopy Asia that whenever a patient is subjected for
colonoscopy, we always make an attempt to have inspection of terminal ileum in
all patients, more so if we are suspecting any bleeding lesions. It is
important to have all therapeutic options available as we know there are
mechanical and thermal methods of haemostasis. Here we felt that bipolar heater
probe coagulation was effective and it provides complete fulguration of the
lesion, however, one has be cautious as the wall of caecum is thinnest compared
to other parts of the colon. Optimal bowel preparation is the key.
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1.Classical
angiodysplasia seen in caecum
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2.
Angiodysplasia seen on NBI in caecum
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3.The lesion was
fulgurated with bipolar heater probe
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4. Post
fulguration complete haemostasis achieved
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