Clinical Significance of Colonoscopy in Patients with Benign Anorectal Disease.
- Author:
Kyung Bo KIM
1
;
Hyun Chul PARK
;
Jae Hwan OH
Author Information
1. Department of Surgery, Gachon Medical School, Gil Medical Center, Inchon, Korea. jayoh@ghil.com
- Publication Type:Original Article
- Keywords:
Benign anorectal disease;
Colonoscopy
- MeSH:
Adenoma;
Angiodysplasia;
Colitis;
Colon;
Colonoscopy*;
Colorectal Neoplasms;
Diagnosis;
Diverticulum;
Fistula;
Hemorrhage;
Hemorrhoids;
Humans;
Ileitis;
Inflammatory Bowel Diseases;
Melanosis;
Pathology;
Polyps;
Retrospective Studies;
Sigmoidoscopy;
Ulcer
- From:Journal of the Korean Society of Coloproctology
2001;17(4):181-186
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE:Benign anorectal disease will often cause great concern to the patient and the practitioner about a more proximal colon pathology. The aim of this study is to evaluate the significance of routine colonoscopy for patients with benign anorectal disease. METHODS:A retrospective analysis of 108 patients with benign anorectal disease who had undergone colonoscopic examination from April 1997 to August 1998 at Gil Medical Center was done. RESULTS:The mean age of all patients was 43 years; the male-to-female ratio was 1:1.1. The diagnoses of anorectal disease were hemorrhoids in 84 cases, anal fissures in 13 cases, chronic anal pain syndrome in 6 cases, anorectal fistulas in 5 cases, and other in 9 cases. There were 37 patients (34.3%) with 53 abnormal findings:14 tubular adenomas, 11 inflammatory polyps, 4 hyperplastic polyps, 1 tuberculous colitis, 1 angiodysplasia, 6 diverticula, 6 nonspecific ileitis or colitis, 2 melanosis coli, 2 rectal ulcers, 2 ileal ulcers, and 3 other diseases. Among them, clinically significant lesions, such as neoplastic lesion, tuberculous colitis and angiodysplasia, were detected in 12 patients (11.1%). Because the lesions in 7 patients of the 12 patients were within the reach of sigmoidoscopy, only 5 patients (4.6%) needed a colonoscopic examination. In regard to neoplasms, patients presenting with anal bleeding and old age were not found to have a higher frequency of neoplasia. Also, the specific type of anorectal disease was not associated with an increased risk for colorectal neoplasia (P>0.05). CONCLUSIONS:Sigmoidoscopy is a more acceptable primary diagnostic tool in patients with benign anorectal disease, but in patients with gastrointestinal symptoms, a high risk for colorectal cancer, suspicious inflammatory bowel disease, or fear of cancer, selective colonoscopy will be needed.