Rectocolonic echoendoscopy

"Echoendoscopy is a very useful diagnostic technique, since it allows us to take samples of the lesions found and even apply the appropriate treatment. All of this, in the same procedure".

DR. JOSÉ CARLOS SÚBTIL ÍÑIGO
SPECIALIST. DIGESTIVE DEPARTMENT

Echoendoscopy is a diagnostic technique and, in some cases, with the possibility of applying treatments, which consists of the combination of a flexible endoscope and an ultrasound device.

By using an ultrasound probe, it is possible to obtain much clearer images and a more detailed visualization of the different layers that make up the wall of the digestive tract.

It is a difficult technique to interpret, so it is very important that it is always performed by a specialized physician.

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When is rectocolonic echoendoscopy indicated?

With this technique, performed by anal way, it is possible to explore from the external margin of the anus up to 30 or more centimeters towards the interior.

The anal canal and the anal sphincters, a large part of the pelvic floor, the walls of the rectum and the last part of the large intestine can be explored with precision.

In addition, other organs can be visualized, such as the prostate and seminal vesicles in the case of the male; and the vagina, part of the uterus and sometimes the ovaries, in the case of the female.

The urethra, bladder, and part of the floor of the peritoneal cavity that is closest to the rectum can also be studied. All of these areas are within the rigid structure of the pelvis and are difficult to access by other means without resorting to overly aggressive procedures.

Most frequent indications of this test:

  • Perianal abscess.
  • Colorectal cancer.
  • Anal fistulas.
  • Urinary incontinence.
  • Follow-up after rectal tumor surgery.

This test is indicated to rule out both tumor and non-tumor processes.

In the study of tumours, it is indicated for the in-depth study of some inestinal polyps, cancers of the rectum and anus and the last section of the large intestine, the study of tumours of the genitourinary area lodged in the pelvis and the study of other pelvic masses found in other explorations carried out previously on the patient.

In addition, it is indicated in the follow-up of patients undergoing chemical or radiotherapy treatments to assess the progress of the disease.

Among the non-tumoral indications are fistulas, perianal, perirectal and pelvic abscesses, the study of incontinence and unexplained anal or pelvic pain.

Do you have any of these diseases?

You may need to have a rectocolonic echoendoscopy

How is rectocolonic echoendoscopy performed?

For the images to be of adequate quality, to avoid infections if a biopsy is needed and to protect the echoendoscope from possible damage, the colon needs to be as clean as possible.

Ideally, a preparation for cleaning the colon should be made as for a colonoscopy, with special laxatives taken by mouth.

In some special cases (immobile patients, very old, debilitated or with intolerance to the preparation...), a cleaning with enemas can be done, knowing that it is not usually of as much quality as the preparation taken by mouth.

The most used posture is lying down from half side to the left. The test is not especially troublesome and if the anus or colon are not inflamed, it is well tolerated. Sometimes, it is advisable to use some kind of sedation or anesthesia.

The preparation, in general, is the same as for gastroscopy or colonoscopy, depending on whether it is an upper or lower endoscopy.

If it is an upper endoscopy, it is necessary to fast for at least 6 hours, including water. If you are obliged to take any medication, you will do so with a minimum amount of water and will inform the doctor who will perform the test.

If it is a lower endoscopy, you will have to take the previous day a preparation with strong laxatives or enemas that will adequately clean the large intestine.

If you present any alteration in the coagulation of the blood or take medication that alters it, you will communicate it before having the test, especially if in this one a puncture is going to be realized to obtain material.

If the patient is allergic to latex, he should warn you before the test.

It is convenient to come accompanied by a family member or friend.

Once the exploration is over, if it has been done under anesthesia, you will have to wait for a while until the anesthesiologist discharges you and you can leave the endoscopy unit.

You must wait a few minutes before trying to take liquids or food, since this may cause you to choke or vomit due to the anesthetics used.

You should not drink alcohol or drive for the next 24 hours.

If the exploration has been rectal and without sedation or anesthesia, you will usually be able to return to your normal life almost immediately. Some temporary discomfort may remain after the exploration, such as sore throat and bloating and/or abdominal pain due to gas retention.

Usually, most ultrasound scans are done on an outpatient basis. In some cases, when an exploration of both the upper and lower digestive tract is to be performed, in which it is necessary to perform some therapeutic maneuver or puncture, depending on the characteristics of this, hospitalization will be recommended for better preparation and subsequent control.

Echoendoscopy is a "minimally invasive" technique. Among the side effects, the most frequent is pain that can be felt during or after the test.

Its causes are the manipulation itself and the air that may have been trapped in the intestine and could not be removed at the end of the test. It is more frequent for patients who already have a known cause to present pain, such as anal fissures, thrombosed hemorrhoids, abscesses, etc.)

The most important complications can be perforation, infection and bleeding. In expert hands, these types of complications appear in a small number of patients (1 out of every 100) and are normally associated with other existing diseases that favor the appearance of these problems.

Where do we do it?

IN NAVARRE AND MADRID

OUR MEDICAL TEAM

Specialists of the Digestive Department

The Digestive Department of the Clinica Universidad de Navarra is composed of a multidisciplinary team of specialists who are experts in the diagnosis and treatment of diseases of the digestive tract.

Our objective is that each diagnosis be carefully established and the treatment plan adjusted to each patient.

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Why at the Clinica?

  • Medical specialists who are national references.
  • Specialized nursing team.
  • Endoscopy Unit and High Risk Digestive Tumor Prevention and Consultation Unit to offer the best care to our patients.

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