DATE OF PROCEDURE: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: History of recurrent sigmoid diverticulitis.
POSTOPERATIVE DIAGNOSIS: History of recurrent sigmoid diverticulitis.
PROCEDURE PERFORMED: Flexible colonoscopy to cecum.
ANESTHESIA: Intravenous Versed and Demerol.
COMPLICATIONS: None.
INDICATION FOR PROCEDURE: This is a patient with known diverticular disease, who presents with recurrent episodes of sigmoid diverticulitis, requiring antibiotic therapy. The patient will now undergo planned flexible colonoscopy to the cecum in order to evaluate his colon prior to planned elective laparoscopic sigmoid colectomy.
DESCRIPTION OF PROCEDURE: The patient was transported to the endoscopy suite and placed in the left lateral decubitus position. Following administration of intravenous Versed and Demerol to achieve a satisfactory level of anesthesia, the flexible Olympus colonoscope was introduced transanally and threaded proximally through the sigmoid, descending, transverse, and ascending colon to the level of the cecum. The ileocecal valve was visualized, and the cecal mucosa was carefully inspected. No diverticula, polyps or other neoplastic changes were present.
The scope was then withdrawn through the ascending, transverse, and descending colon with the mucosa again being carefully inspected. There were scattered diverticula in the ascending colon and multiple diverticula within the proximal transverse colon, without evidence of diverticulitis or bleeding. No polyps were present. The proximal descending colon appeared to be free of diverticulosis and inspection of the distal descending and sigmoid colon revealed extensive diverticular disease with muscular hypertrophy of the wall from 45 cm to 18 cm from the anal verge. Small ulcerations were present without evidence of bleeding. No polyps were identified. The mucosa of the rectosigmoid colon and rectum was grossly normal.
Retroflexion of the scope revealed minimal internal hemorrhoids without evidence of bleeding. The scope was completely withdrawn, and the patient appeared to tolerate the procedure well.
IMPRESSION AND PLAN: The patient has evidence of extensive diverticular disease within the sigmoid colon and will undergo planned elective laparoscopic sigmoid colectomy. He has been instructed to continue on his dietary modification as well as daily use of a fiber supplement.
