ABSTRACT
Colonoscopy should be delivered by endoscopists performing high quality procedures. The British Society of Gastroenterology, the UK Joint Advisory Group on GI Endoscopy, and the Association of Coloproctology of Great Britain and Ireland have developed quality assurance measures and key performance indicators for the delivery of colonoscopy within the UK. This document sets minimal standards for delivery of procedures along with aspirational targets that all endoscopists should aim for.
Subject(s)
Adenoma/diagnosis , Clinical Competence , Colonic Neoplasms/diagnosis , Colonic Polyps/diagnosis , Colonoscopy/standards , Early Detection of Cancer , Quality Assurance, Health Care/standards , Adenoma/surgery , Biopsy/standards , Clinical Competence/standards , Colonic Neoplasms/surgery , Colonic Polyps/surgery , Colonoscopy/adverse effects , Conscious Sedation/standards , Early Detection of Cancer/methods , Early Detection of Cancer/standards , Gastroenterology/standards , Humans , United KingdomABSTRACT
Chronic idiopathic intestinal pseudo-obstruction (CIIP) is a rare syndrome of ineffectual gut motility associated with clinical, endoscopic and radiological exclusion of mechanical causes, as well as evidence of air-fluid levels in distended bowel loops. A case of small bowel volvulus in a patient with an established diagnosis of CIIP is presented. The case is illustrated by images of operative findings and computed tomography scan reconstruction, showing the classical appearances of small bowel volvulus. The patient recovered well after surgery and is maintained on parenteral nutrition. CIIP is a heterogeneous disorder in which the primary aims of management are nutrition, pain control and the avoidance of unnecessary repeated laparotomies. However, even in the presence of an established diagnosis of CIIP, surgeons should be vigilant to the possibility that an operable mechanical obstruction may still occur.