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Objective: We aimed to compare the effects of propofol via target controlled infusion (TCI) or intermittent bolus (B) method on propofol consumption, hemodynamics, patient's comfort and recovery in colonoscopies. Materials and Methods: Following Ethical Committee's approval, 66 patients, (ASA I-II, 18-65 yrs) were allocated to one of two groups receiving propofol administered a either TCI or intermittent bolus (B) supplemented with remifentanil (0,05 μg kg min-1 iv). After 2 minutes, iv propofol was titrated as 0,5 μg mL-1 effect-site concentration and as 0,25 mg kg-1 bolus increments to achieve Ramsey Sedation Score of 3-4 in Groups TCI and B, respectively. Hemodynamic and respiratory parameters, total propofol requirements, the incidence of recall and dreaming, pain intensity, patient satisfaction, time to opening eyes, and also to recovery were recorded. Results: Heart rate increased significantly at first 1.-2. min in Group TCI (p<0,05- p<0,01), and measurements at all time-points except at 5 min in Group B (p<0,01) compared with baseline. Mean arterial pressure was significantly higher in Group B at 5., 6., 7. and 8. min than the corresponding values in Group TCI (p<0,05- p<0,01). Recall, dreaming, pain intensity, total propofol dose, time to eye opening, recovery and patient satisfaction did not change between the groups. Conclusion: Our results suggest that propofol TCI does not confer any benefit over bolus propofol with respect to drug consumption and recovery profile for sedation in colonoscopy. However, propofol TCI rather than bolus propofol may be a better choice for the prevention of hemodynamic response during colonoscopy. [ABSTRACT FROM AUTHOR]

Flexible colonoscopy is the gold standard in diagnosis, treatment, and follow-up of colonic pathologies. The acute onset of abdominal pain after colonoscopy may be a clinical sign of colonic perforation. Perforation rate after diagnostic colonoscopies varies between 0.01%-0.4%. If the patient develops signs of peritoneal irritation, the surgical intervention is obligatory. According to the literature, early surgical treatment is the best strategic approach that decreases the morbidity and mortality. Nonoperative treatment could be a choice in selected patients without signs of peritoneal irritation. In large colonoscopy series, only 1-5% of the cases with colonic perforation secondary to the colonoscopy were treated conservatively. We reported a case with colonic perforation after diagnostic colonoscopy which we successfully treated nonoperatively without further need of surgery. [ABSTRACT FROM AUTHOR]

Intestinal malrotation is a congenital anomaly that generally becomes symptomatic during the neonatal period. However, it rarely occurs in adulthood, and synchronous colon cancer is uncommon. We presented a case of a 80-year-old patient with intestinal malrotation and concomitant cancer of the sigmoid colon. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the diagnostic value of colonoscopy in patients with nonspecific abdominal pain Patients and Methods: A prospective observational study was performed at the department of general surgery between March 2006 and March 2009. All patients with abdominal pain (n: 2.604) were evaluated carefully. After a detailed anamnesis, physical examination, laboratory and radiological evaluation, the patients with nonspecific abdominal pain were invited for a colonoscopic examination. Results: Colon cancer was detected in three of the patients aged 59, 63 and 68 years old. Other nine had pedunculated polyps with dysplasia in three of them. Neither had pedicle invasion. Millimetric hyperplastic polyps were detected in 16 other patients. A hundred and ninety eight patients had colonic diverticula. Seventeen of the 25 patients with polyps and 127 of the patients with diverticula were over age 50 years. Conclusion: The value of colonoscopic examination is still controversial in patients with nonspecific abdominal pain. Although the detection rate of malignant and pre-malignant lesions are low, the high detection rate of diverticula and the low complication rate due to the procedure are in favour of colonoscopic examination in these patients. [ABSTRACT FROM AUTHOR]

Splenic flexure volvulus is the rarest type of colon volvuli, and very few cases of splenic flexure volvulus have been reported in the literature. Patients usually present with complaints of recurrent obstruction and distention attacks. For the definitive treatment, the volvulus segment should be resected and end-to-end anastomosis should be performed afterwards. We present a 16-year-old patient with primary splenic flexure volvulus and a history of Hirschsprung's disease. After having been treated with several conservative colonoscopic reductions, the patient was electively operated. Since he is the first splenic flexure volvulus case with Hirschsprung's disease in the literature who underwent a successful colonoscopic reduction, this case was found to be noteworthy. [ABSTRACT FROM AUTHOR]

In hematopoietic malignancies, the cause of bleeding from gastrointestinal system (GIS) can be multifactorial, such as infiltration of the hematopoietic disease, mucosal changes due to bone marrow suppression and chemotherapy, infections, and peptic ulcers. Arteriovenous malformations of the gastrointestinal tract are an unusual cause. Acute massive hematochezia is one of the greatest diagnostic and therapeutic challenges for the physician. It is a complex problem that requires disciplined and careful evaluation for successful management. Prompt colonoscopy for acute lower gastrointestinal (LGI) bleeding can be performed with a high rate of success for localizing, and sometimes treating the cause of LGI bleeding. The role of prompt esophagogastroduodenoscopy (EGO) and colonoscopy for upper and lower gastrointestinal bleeding (GIB) is well defined., However, enteroscopy can also provide both diagnosis and therapy for patients with massive lower gastrointestinal bleeding. Here we present a case with non-Hodgkin lymphoma who had a life-threatening GIS bleeding due to an arteriovenous malformation. [ABSTRACT FROM AUTHOR]