TIA
Melissa Bedford,CCS,CPC
Procedure: Flexible sigmoidoscopy with placement esophageal covered stent.
Indications: Colonic obstruction due to stricture of ansstomosis
Is this the patient's first screening/surveillance colonoscopy?: no
Sedation:
Anesthesia oversaw sedation and drugs were administered incrementally over the course of the procedure to achieve an adequate level of conscious sedation. Please see their documentation for full details.
Procedure Details:
Medications were reconciled, time out was performed, cardiopulmonary status was assessed and determined to be satisfactory, and informed consent was obtained. The patient was placed in the left lateral decubitus position and monitored continuously with ECG tracing, pulse oximetry, blood pressure monitoring and direct observations.
After anorectal examination was performed, the Colonoscopy was performed. The colonoscope was inserted into the rectum and advanced under direct vision to the patient's known colonic stricture; a small opening was noted. The scope was then advanced through this opening without difficulty. A Savary-Gilliard wire was then passed through the stricture, and position noted fluoroscopically. A Wall flex covered esophageal stent 23 mm X 105 mm with distal flare 28 mm was passed over the wire through the anastomosis and deployed under fluoroscopic and endoscopic visualization. Final position noted to be satisfactory. The colonoscope was withdrawn after decompression of the bowel. The patient tolerated the procedure well, and there were no immediate complications.
Findings: Stricture of the anastomosis at about 26 cm from the anal verge
Additional Interventions:
On Colonoscopy: placement of covered stent
Complications:
None
Impression:
Colonoscopy revealed: See above findings
Recommendations:
Follow up with ETS in 2 weeks
Melissa Bedford,CCS,CPC
Procedure: Flexible sigmoidoscopy with placement esophageal covered stent.
Indications: Colonic obstruction due to stricture of ansstomosis
Is this the patient's first screening/surveillance colonoscopy?: no
Sedation:
Anesthesia oversaw sedation and drugs were administered incrementally over the course of the procedure to achieve an adequate level of conscious sedation. Please see their documentation for full details.
Procedure Details:
Medications were reconciled, time out was performed, cardiopulmonary status was assessed and determined to be satisfactory, and informed consent was obtained. The patient was placed in the left lateral decubitus position and monitored continuously with ECG tracing, pulse oximetry, blood pressure monitoring and direct observations.
After anorectal examination was performed, the Colonoscopy was performed. The colonoscope was inserted into the rectum and advanced under direct vision to the patient's known colonic stricture; a small opening was noted. The scope was then advanced through this opening without difficulty. A Savary-Gilliard wire was then passed through the stricture, and position noted fluoroscopically. A Wall flex covered esophageal stent 23 mm X 105 mm with distal flare 28 mm was passed over the wire through the anastomosis and deployed under fluoroscopic and endoscopic visualization. Final position noted to be satisfactory. The colonoscope was withdrawn after decompression of the bowel. The patient tolerated the procedure well, and there were no immediate complications.
Findings: Stricture of the anastomosis at about 26 cm from the anal verge
Additional Interventions:
On Colonoscopy: placement of covered stent
Complications:
None
Impression:
Colonoscopy revealed: See above findings
Recommendations:
Follow up with ETS in 2 weeks