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Would It Be Difficult To Examine The Cecum With A Tradiomal Visual Colonoscopy?

Posted on Mon, 9 Oct 2023

Question: I had s virtual colonoscopy and the gastroentesttional radiologist who reAd the scan saidt there was something suspicious in my Cecum but it was hard to tell because the prep was not adequate. He said to be aware it would be very difficult to get to the Cecum with the tradiomal visual colonoscopy . Is this true , I thought it would be good to know before I ser the GI doc. If they can get to the Cecum, I am nervous about cutting sny large polyp and allowing possible cancer cells to float through my GI tract. Can you help. XXXXXXX

Answered by Dr. Ramesh Kumar (5 hours later)

Brief Answer:
Colonoscopy is investigation of choice to visualise colon.

Detailed Answer:
Hello my dear patient,
Have gone through your query,
Firstly i would say that a colonoscopy is the best test for visually detecting a cancer of the cecum. In a colonoscopy, through colonoscope your entire colon up to the cecum can be seen clearly.If polyps are detected, they can be removed and could be sent for biopsy.
Infact its the investigation of choice.I don't know why radiologist said so.Caecum can easily be visualised by colonoscopy.
I don't think you need to worry too much traditional colonoscopy is investigation of choice.A biopsy sample from polyp would be taken to see if its benign or malignant.Had radiologist given you any reason why colonoscopy will not be helpful to you?
Waiting.
Regards!

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (10 hours later)

The radiologist said its virtually impossible to reach all the way to the cecum with a visual pediatric scope. Some GI docs say that they will try to get the visual scope all the way to the cecum but they cannot guarantee that they can, they will try their best. I have seen academic studies that say their typically a 10% or higher probability that the scope will NOT get to the cecum. Other GI docs say its easy.
SO I am very confused. I think I may have not communicated properly with my first
question. The radiologist only said that its very difficult to get to the cecum and some GI docs agree. I am thinking about another colonoscopy or even a petscan to see if there is anything there. I had hernia surgery on march 12th and have to wait until at least mid XXXXXXX to have a colonoscopy. Maybe longer because after surgery I had a BIG hematoma 10cm by 5 by 6 next to my left testicle in the scrotum and they said it would take two months before its gone,but it is almost two months and its only reduced by about 30%. I see the surgeon next week and they may drain the hematoma. I dont know why the hematoma is not gone and if its presence could delay a colonoscopy. thanks

Answered by Dr. Ramesh Kumar (17 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hello again,
I don't think that there is any need to panic.
Caecum usually is easily seen on colonoscopy.
Yes any procedure like colonoscopy won't be done on a patient already having complications as a part of other surgery.
A better way is to go for a PET scan as it would be done and is non invasive and any major life threatening pathology could be ruled out after delay.
Once hematoma thing is fine you could go for planned colonoscopy.
Practically no test is always successful but failure rate with colonoscopy are quiet low.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramesh Kumar (6 hours later)

The information is very helpful, but I am confused about one thing. You say colo not usually done on patient already has complications from another surgery. Is the hematoma considered a complication from a previous surgery that would mean not to do a colonoscopy at this time?-marty

Answered by Dr. Ramesh Kumar (45 minutes later)

Brief Answer:
follow up.

Detailed Answer:
Hello again,
See my dear patient i would give you an example.Suppose a patient has to go for a routine test but has fever on that day so doctors would wait for fever to subsite to intervene into body.
Usually its not good to intervene when a second problem is ongoing.
Hope you understand what you mean to see.
Thanks.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramesh Kumar (50 minutes later)

thanks for your reply.
I am wondering if the video capsule would be able to visualize anygrowth in the Cecum? XXXXXXX

Answered by Dr. Ramesh Kumar (18 minutes later)

Brief Answer:
follow up.

Detailed Answer:
Hello again dear,
Some times video capsule get impacted in gut but yes its a ok option.
However if money is not an issue go for PET scan.
Thanks.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramesh Kumar (3 days later)

I do not think you answered my complete question. I wanted to know if getting a biopsy from a large polyp could allow cancer cells to float through the body? oiginal question-- ---' I am nervous about cutting sny large polyp and allowing possible cancer cells to float through my GI tract. Can you help. I have scheduled a petscan. Waiting to see if blood work indicaates a possible problem with scan. ,, XXXXXXX

Answered by Dr. Ramesh Kumar (16 hours later)

Brief Answer:
follow up.

Detailed Answer:
Hello again dear,
I'm sorry that I failed to understand your query properly.

The answer to your query is-

No, biopsy won't cause metastasis of cells of the polyp from one place to other. Its not possible. Metastasis or transfer of cells from one place to other in the body is a complex bodily procedure and it has no relation to biopsy. Cells can't just float. Metastasis is a very complex procedure. So, my answer is: it's not possible.

So please don't panic.
Follow up with reports of PET scan.

Wish you a good health.
Hope you would recover soon XXXXXXX
Regards!

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Above answer was peer-reviewed by : Dr. Arnab Banerjee