Diagnoses
Near obstructing colonic mass at 40 cm
2 cm polyp at 20 cm
Operation
Incomplete colonoscopy with biopsy of the mass.
Sigmoid polyp
Indications
Patient comes to us after presenting the emergency room earlier this week with abdominal pain and was diagnosed with presumed carcinomatosis ascites liver metastases and a stricturing lesion of the proximal sigmoid colon by CT. He is without a sense of obstipation or constipation. He did tolerate his bowel prep.
Description
Digital exam was unremarkable. I used the adult endoscope to get her approximately 40 cm. With a water lavage technique I could identify a concentric lumen about inflamed mucinous circumferential abnormal tissue. I attempted to use a pediatric scope. I could not cross this area.
I took several cold biopsies of the area. Approximately 35 cm there is a quarter sized area that appeared hypervascular and I elected not to biopsy this. At 20 cm there is a pedunculated polyp that was irregular and approximately 2 cm that was removed by snare cautery.