Sigmoidoscopy

Sigmoidoscopy is a simple and easy method to detect high-grade masses that cannot be detected by rectal examination. At the same time, tissue biopsy is performed on suspicious lesions, and the nature is clear. Therefore, sigmoidoscopy can be used for diagnosis and as a therapeutic instrument, which is of great significance for prevention and early detection of rectal and sigmoid colon cancer. Basic Information Specialist classification: Digestive examination classification: endoscope Applicable gender: whether men and women apply fasting: not fasting Tips: 3 days before the test, stop taking iron preparations and start eating semi-liquid or low-slag diet. Normal value normal. Clinical significance Sigmoidoscopy is used to examine inflammation of the rectum and sigmoid colon, ulcers, polyps, tumors, parasitic lesions, and unexplained diarrhea. It can be used to take live tissue specimens during inspection. Precautions 1. Three days before the examination, stop taking iron preparations and start eating semi-liquid or low-slag diets such as fish, eggs, milk, soy products, porridge, noodles, bread, bananas, melon, potatoes, etc. Check the diet on the day without slag juice or fast. 2. Take the laxatives, such as castor oil, senna, and drink plenty of water the night before. 3. Clean the enema two hours before the test. Quiet rest for half an hour before the check. 4. Subcutaneous injection of sedatives and atropine in the first 20 minutes of the examination. Patients with glaucoma or enlarged prostate are exempt from use and can be used with diazepam 10 mg. 5. Listen carefully to the doctor's introduction and inspection process before the examination to relieve ideological concerns. 6. Patients should be replaced with sterile examination pants before examination. During the examination, the patient takes the left lateral position, the abdomen relaxes, and bends the knee. Then, follow the doctor's instructions and turn to change position as required. 7. If there is pain during the examination, immediately tell the doctor that it is convenient for the doctor to insert the mirror safely. 8. Rest for 1 day after the examination. If there is severe abdominal pain, bloating, blood in the stool, etc., you should go to the hospital for emergency treatment immediately. 9. Serious heart disease, cardiopulmonary insufficiency, severe hypertension, acute diarrhea, severe ulcerative colitis, colonic Crohn's disease, peritonitis, pregnancy, mental illness, abdominal surgery and obvious intestinal adhesion are prohibited. Item check. 10. If a biopsy is performed, do not do strenuous activities within 3 days after surgery. Inspection process The main methods of hard tube sigmoidoscopy are as follows: 1. The patient takes the chest and knees, removes all the pants to the knee joint, completely exposes the buttocks, and the head can turn to the left side. 2. First do an anal finger examination, check whether the anus has an anal fissure, skin sputum, anal fistula, external hemorrhoids, rectal prolapse, with or without a lump, pay attention to the extent, size, location of the lesion, with or without tenderness. 3. Apply a little oil to the anus and the body of the lens. Insert the sigmoidoscope with the inner core slowly from the anus to about 3cm, then remove the inner core, turn on the light source, change the orientation to find the intestine, and then slowly enter the mirror until the cavity continues. Insert the lens body all the way. If there is intestinal fistula, or the intestinal lumen is continuously locked, the intestine cavity can be inflated, the intestinal lumen can be dilated, and the cavity can be followed by the cavity. Observe mucosal color, with or without congestion, edema, swelling and ulcers, pay attention to texture and bleeding. 4. See the lesions, whether it is benign or malignant should take more than 2 tissues, immediately put in 4% formaldehyde (10% formalin solution) fixed, and labeled for biopsy. 5. For polyps, it is necessary to see the size of the polyp, the surface is smooth, whether there is pedicle, if there is pedicle for sigmoid colon polyp trap or electrocautery resection, the complete polyps will be sent to the pathological examination, and the patient is recommended to do the whole colon Microscopic examination, except for polyps in other parts of the colon. 6. If you see a distal tumor of the rectum or sigmoid colon, you should see the size of the tumor, the distance to the anus and the extent of the intestinal lumen, and a biopsy should be performed. 7. After taking biopsy tissue, a little local oozing, no need to deal with, such as active bleeding, can use dry cotton ball to stop bleeding for more than 3min, a large number of bleeding, plus sputum with norepinephrine Vaseline gauze padding And appropriate rehydration, add a hemostatic agent. 8. After the end of the examination, rest for about 15 minutes, you can eat, generally does not affect normal work. 9. Patients with chronic schistosomiasis should take biopsy and make a print test. 10. If necessary, take the mucus secretion in the intestinal cavity for bacterial culture and smear to find amoeba. Not suitable for the crowd 1. Acute suppurative inflammation of the anus, rectum or sigmoid colon. 2. Anal fissure. 3. Severe bleeding disorders. 4. Severe high blood pressure or heart disease. 5. A large amount of ascites or physical deterioration is severe. Adverse reactions and risks There may be abdominal pain, bloating, blood in the stool, etc.