Flexible Sigmoidoscopy. Scott M. Strayer, MD, MPH Assistant Professor University of Virginia Health System Department of Family Medicine. A Case. 45 yo male presents with rectal bleeding X1. Physical exam reveals small non-thrombosed hemorroid. What other history would you like to have?
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Scott M. Strayer, MD, MPH
University of Virginia Health System
Department of Family Medicine
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FIGURE 1.Hooking and straightening technique used to pass through a tortuous sigmoid colon. (A) The scope is inserted to the angled sigmoid. (B) The scope tip is turned to a sharp angle, and the sigmoid is hooked as the scope is withdrawn. (C) The sigmoid is straightened as the scope is withdrawn. The scope can then be inserted through to the descending colon.Techniques
FIGURE 2.Paradoxic insertion. (A) The scope is bowing out the sigmoid colon, which has a mobile mesenteric attachment. (B) Paradoxic insertion describes the insertion of the tube without advancement of the scope tip. Paradoxic insertion can be very uncomfortable for the patient.Other Techniques