Case 85: Unusal view at endoscopy
A first year registrar is performing a colonoscopy and is confused.
1. What view has been attained by the registrar?
A retroflexed view in the rectum looking at the anal canal from above. See the scope as a black tube superiorly.2. Is this maneouvre indicated in usual circumstances?
Yes, it does have the small risk of rectal perforation if not performed delicately, however it shows a good view of the internal haemorrhoidal plexus and any polyps etc just above the anorectal ring. These problems can be easily missed, especially if a digital rectal examination is not performed at the beginning of the procedure. This part of the colonoscopy is advocated by the American Gastroenterological Association.American Gastroenterological Association endoscopy guidelines