1123 An Audit of Pick-Up Rate of Random Colonic Biopsies

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Zulfiqar ◽  
H Baig ◽  
M Buksh
Keyword(s):  
Histopathological Examination ◽  
Diagnostic Yield ◽  
Health Resources ◽  
Microscopic Colitis ◽  
Random Biopsy ◽  
Bowel Habits ◽  
Colonic Biopsy ◽  
Optimum Utilization ◽  
The Cost ◽  
Colonic Biopsies

Abstract Aim We aimed to evaluate optimal random biopsy criteria are being followed in our institution to increase the diagnostic yield of a subsequent histopathological examination and to reduce the number of unnecessary biopsies in which histopathology is unlikely to deliver clinically useful information and causing a burden on health resources in terms of cost and manpower. Method Our study was a retrospective on 419 random colonoscopy biopsies performed over 6 months. Data collection included variables such as age, gender, indications, request of urgency, and histology findings. Data analysis was done descriptively. Results Out of 419 random biopsies, only 10.02% had positive findings. The total number of histology results with microscopic colitis was 10. The main indication of the random colonic biopsy was a change in bowel habits (328 cases) followed by significant diarrhea greater than 50 years in 20 cases. In patients with a change in bowel habits, 2.44% of histopathology specimens revealed microscopic colitis. The percentage of random colonic biopsy histology in patients greater than 50 years with significant diarrhea showed microscopic colitis was 10%. Conclusions Our study revealed random biopsy during colonoscopy should only be done in selected patients otherwise it has low diagnostic yields biopsy and should only be reserved for patients with risk factors for optimum utilization of health resources and to reduce the cost burden. A scoring system may be helpful to risk-stratify patients in low and high risk for MC to determine which patients qualify for RCB.

Microscopic Colitis: Endoscopic Performance and Diagnostic Yield

2021 ◽  
Author(s):  
M Linhares ◽  
D Ramos ◽  
F Pereira ◽  
I Pestana ◽  
J Pinto ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Microscopic Colitis

scholarly journals Familial Microscopic Colitis

2001 ◽  
Vol 15 (5) ◽  
pp. 341-343 ◽  
Author(s):  
Ayman Assad Abdo ◽  
Peter Jeffrey Zetler ◽  
Lawrence S Halparin
Keyword(s):  
Chronic Diarrhea ◽  
Present Report ◽  
Disease Process ◽  
Collagenous Colitis ◽  
Microscopic Colitis ◽  
Familial Occurrence ◽  
Lymphocytic Colitis ◽  
The Third ◽  
Inflammatory Conditions ◽  
Colonic Biopsy

Collagenous and lymphocytic colitis are two inflammatory conditions of the colon that are often collectively referred to as microscopic colitis. The present report describes what is believed to be the third published case of familial microscopic colitis. A 55-year-old woman who suffered from chronic diarrhea was diagnosed with lymphocytic colitis on colonic biopsy. Subsequently, her 36-year-old daughter was diagnosed with collagenous colitis. The familial occurrence of these diseases may support an immunological hypothesis for their etiology. In addition, it supports the assumption that collagenous and lymphocytic colitis are two manifestations of the same disease process rather than two completely separate entities. The familial tendency of this disease may make a case for early colonoscopy and biopsy in relatives of patients diagnosed with microscopic colitis if they present with suggestive symptoms.

scholarly journals Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2240
Author(s):  
Soo-Young Na ◽  
Yun-Jeong Lim
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Postoperative Recurrence ◽  
Treat To Target ◽  
Diagnostic Modality ◽  
Colon Capsule Endoscopy ◽  
Bowel Diseases ◽  
Colon Capsule ◽  
The Cost

Capsule endoscopy (CE) has proven to be a valuable diagnostic modality for small bowel diseases over the past 20 years, particularly Crohn’s disease (CD), which can affect the entire gastrointestinal tract from the mouth to the anus. CE is not only used for the diagnosis of patients with suspected small bowel CD, but can also be used to assess disease activity, treat-to-target, and postoperative recurrence in patients with established small bowel CD. As CE can detect even mildly non-specific small bowel lesions, a high diagnostic yield is not necessarily indicative of high diagnostic accuracy. Moreover, the cost effectiveness of CE as a third diagnostic test employed usually after ileocolonoscopy and MR or CT enterography is an important consideration. Recently, new developments in colon capsule endoscopy (CCE) have increased the utility of CE in patients with ulcerative colitis (UC) and pan-enteric CD. Although deflation of the colon during the examination and the inability to evaluate dysplasia-associated lesion or mass results in an inherent risk of overestimation or underestimation, the convenience of CCE examination and the risk of flare-up after colonoscopy suggest that CCE could be used more actively in patients with UC.

Sa1110 Random Colonic Biopsies in Diagnosing Microscopic Colitis: Low Yield High Cost

2016 ◽  
Vol 150 (4) ◽  
pp. S243
Author(s):  
M. Syafiq Ismail ◽  
Olufemi Aoko ◽  
Grace Kavanagh ◽  
Lisa Brandon ◽  
Rachael Flood ◽  
...  
Keyword(s):  
Microscopic Colitis ◽  
Colonic Biopsies

Family Medicine and the Health Care Crisis in the United States

1972 ◽  
Vol 2 (2) ◽  
pp. 207-215
Author(s):  
R. Smith
Keyword(s):  
Family Medicine ◽  
Medical Care ◽  
Health Resources ◽  
Major Change ◽  
The United States ◽  
Cost Of Care ◽  
Flexner Report ◽  
New Feature ◽  
The Cost ◽  
Governmental Response

Many millions of Americans are deprived of medical care because of inadequate and poorly distributed health resources. The cost of care has become the most potent single cause for concern, and much of the current governmental response focuses on this issue. The plethora of bills before Congress is considered in this paper and three examples advocating a less or greater degree of change are studied. The universities are responding in a variety of ways, and these include expansion of their service and educational bases into the community. The widespread creation of departments of family medicine is a new feature of American medical education and could constitute a major change in direction equal in significance to change resulting from the Flexner Report. Though greater emphasis on primary medical care is clearly accepted as important by both government and educators, the future is uncertain. Barriers and shortages should disappear in the years ahead, and a great resurgence of family medicine should reintroduce many desired features into practice which are now missing.

scholarly journals Progress and Challenges in Colorectal Cancer Screening

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Enrique Quintero ◽  
Cesare Hassan ◽  
Carlo Senore ◽  
Yutaka Saito
Keyword(s):  
Colorectal Cancer ◽  
Diagnostic Yield ◽  
Proximal Colon ◽  
Screening Tests ◽  
Incidence And Mortality ◽  
Screening Strategies ◽  
The Cost ◽  
New Strategies ◽  
Made In

Although faecal and endoscopic tests appear to be effective in reducing colorectal cancer incidence and mortality, further technological and organizational advances are expected to improve the performance and acceptability of these tests. Several attempts to improve endoscopic technology have been made in order to improve the detection rate of neoplasia, especially in the proximal colon. Based on the latest evidence on the long-term efficacy of screening tests, new strategies including endoscopic and faecal modalities have also been proposed in order to improve participation and the diagnostic yield of programmatic screening. Overall, several factors in terms of both efficacy and costs of screening strategies, including the high cost of biological therapy for advanced colorectal cancer, are likely to affect the cost-effectiveness of CRC screening in the future.

scholarly journals Diagnostic Yield of Medical Thoracoscopy in Undiagnosed Exudative Pleural Effusion- A Tertiary Centre Experience from Aligarh Muslim University, Uttar Pradesh, India

2020 ◽  
Author(s):  
Mohammad Arif ◽  
Rakesh Bhargava ◽  
Mohammad Shameem ◽  
Nafees Ahmad Khan ◽  
Sadaf Sultana
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Histopathological Examination ◽  
Diagnostic Yield ◽  
Uttar Pradesh ◽  
P Value ◽  
Fisher Exact Test ◽  
Pulmonary Medicine ◽  
Medical Thoracoscopy ◽  
Exudative Pleural Effusion

Introduction: Pleural effusions are one of the most common entities encountered by pulmonologists worldwide which have a very long list of causes. Initial workup of these patients begins with a chest X-ray and percutaneous or Ultrasound (USG) guided thoracocentesis followed by biochemical and cytological evaluation of the fluid to ascertain the cause of effusion. A 20 to 25% of cases remain undiagnosed even after thoracocentesis and closed pleural biopsy. Medical Thoracoscopy is emerging as a safe diagnostic procedure in these patients. Aim: To detect the diagnostic yield of medical thoracoscopy in cases of undiagnosed exudative lymphocytic pleural effusion and to study the complications associated with it. Materials and Methods: This was a prospective observational study, carried out in the Department of Pulmonary Medicine, JN Medical College and hospital, Aligarh Muslim University (AMU), Aligarh, Uttar Pradesh, India, from August 2016 to August 2018. Undiagnosed exudative pleural effusion was defined as pleural effusion with Adenosine Deaminase (ADA) levels less than 70 IU/L and negative pleural fluid cytology for malignancy. Thoracoscopic examination of the pleural space using flexi-rigid thoracoscopy was done and biopsy was taken from suspected areas and the tissue obtained, was send for histopathological examination. The results were presented as mean±SD (Standard Deviation) or percentage. Differences in categorical data were compared using the chi-square test or the Fisher-exact test. A p-value of <0.05 was considered statistically significant. Results: Fifty patients underwent thoracoscopy for undiagnosed pleural effusion. Most common gross thoracoscopy finding was nodules which was seen in 23 patients. Malignancy was the most common histopathological finding, seen in 22 patients. Minor complications were seen in five patients. A final diagnosis could be made in 41 patients; the diagnostic yield was 82%. Conclusion: Medical thoracoscopy should be performed in all patients in which radiological and pleural fluid examinations could not lead to a definitive diagnosis as it has high sensitivity and a very low rate of complications.

scholarly journals Indications of Colonoscopy and Their Diagnostic Yield

2021 ◽  
Vol 15 (5) ◽  
pp. 995-998
Author(s):  
M Naveed Anwar ◽  
Humaira Achakzai ◽  
Fahim ullah ◽  
Wajeeha Qayyum ◽  
Zaland Ahmed Yousfzai ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Diagnostic Yield ◽  
Cross Sectional Study ◽  
Deficiency Anemia ◽  
Medical Institute ◽  
Cross Sectional ◽  
Common Indication ◽  
Abnormal Growth ◽  
Bowel Habits ◽  
Internal Hemorrhoids

Aims: To look for common indications and gastrointestinal pathologies observed on colonoscopy and to assess its diagnostic yield with respect to different clinical indications. Study design: Observational cross-sectional study Place and duration of study: Department of Medicine, Rehman Medical Institute from 1st January 2018 to 31st March 2019 Methodology: Five hundred and seventy three patients referred for colonoscopy were included. The demographic profile, indication of colonoscopy and colonoscopy findings were noted. Results: There were 231 (40.3%) males and 342 (59.7%) females with mean age 42.32±17.51 years. Bleed per rectum was most common indication noted in 284 (49.6%) followed by altered bowel habits 125 (21.8%) cases. Two hundred and fifty two (44%) colonoscopies were normal. One hundred and seventy three (30.2%) revealed significant lesions and 148 (25.8%) lesions were insignificant. Internal hemorrhoids were observed in 130 (22.7%) followed by colitis in 54 (9.4%). Abnormal computerized tomography abdomen revealed significant lesions in 62.2% of patients. Chronic diarrhea followed by constipation, altered bowel habits and iron deficiency anemia (IDA) showed 34.5%, 25.7%, 17.6% and <10% significant lesions respectively. Conclusion: Rectal bleed was the most common indication followed by altered bowel habits. Most common colonoscopy findings were hemorrhoids followed by colitis and abnormal growth. Abnormal computerized tomography abdomen gave the best diagnostic yield for colonoscopy. Keywords: Colonoscopy, Indications, Diagnostic yield

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