TRICKY LESION IN SIGMOID DIVERTICULAR SEGMENT скачать в хорошем качестве

TRICKY LESION IN SIGMOID DIVERTICULAR SEGMENT

Lesions in the sigmoid colon  can be difficult to visualise and interpret because of looping, spasm and previous pelvic surgery causing fixation of the bowel. The situation is made worse by the presence of diverticular disease. Sometimes views of a lesion may be suboptimal and fleeting, especially if using a standard adult colonoscope. Lesions can be difficult to photograph (making MDT discussion difficult) and good video footage is essential. Here is a case which exemplifies these difficulties. A 66 year old man had a colonoscopy under the UK Bowel Cancer Screening Programme having been found to be FOB positive using the FIT test. At the index colonoscopy, 5 adenomatous looking polyps were resected  (measuring 3-18mm in diameter) without difficulty from the right and transverse colon. However, on withdrawal through a severely diverticular sigmoid colon, another strange flat lesion was seen (see video). What do you think this lesion  is? 1. Normal mucosa 2. Diverticular colitis / Segmental Colitis Associated with Diverticulosis (SCAD) 3. Adenoma 4. Sessile Serrated Lesion 5. Malignancy 6. Other (what?). The video is 3 min 30 sec long and the answer is given in the last 10 seconds. Make your choice before the answer is shown. Award yourself a cigar if you got the correct answer!