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Colorectal Case 28

Mr. Peter Borch-Johnsen

RN, M.Sci, PhD- Student

Department of Medicine

Ersta Hospital

Department of Medical Sciences

Uppsala University

 

Procedure Information


Scope: PCF-HQ190l

Case Findings: Pedunculated polyp

Organ: Colon, sigmoid

Patient information: N/A

Medical history: N/A

1. Snare polypectomy​

2. Bleeding after polypectomy​

3. Positioning for coagulation​

4. RDI shows clearly the bleeding vessel​

5. RDI after partially coagulated vessel​

6. RDI the bleeding is solved​

Case Video

An approximately 20 mm pedunculated polyp (Paris Ip, JNET 2a) at the distal sigmoid with a slightly eroded and irregular surface due to friction caused by a high peristaltic activity at this level. Underwater colonoscopy causes the polyp to lift up and can be easily captured with the snare. Polypectomy was performed in air phase (Co2). Diathermia resection went rather fast resulting in a pulsating bleeding. RDI mode 1 made easier to detect and coagulated with the tip of the snare. RDI reduced the time to manage the bleeding avoiding major complications.​

Overall Comment

RDI mode 1 seems to enhances the visibility of the bleeding source making haemostasis quicker and easier. It has also a calming effect on the endoscopist and the waken patient as the bleeding perceived as less dramatic.

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