Colon Miscellaneous, El Salvador Atlas of Gastrointestinal VideoEndoscopy. A Large Database of Images and Video Clips with Cases Reported.
El Salvador Atlas of Gastrointestinal VideoEndoscopy

 
Rectal Dieulafoy's lesion. A 62 year-old female who presented with massive hematochezia and who was discovered to have a Dieulafoy's lesion within the rectum. was successfully treated with Argon Plasma Coagulator APC. Dieulafoy's lesions located outside of the stomach are rare occurrences. Lesions found within the colon typically present with painless, massive hematochezia. Colonic Dieulafoy's lesions are rare but should always be considered in the differential diagnosis of massive hematochezia, because endoscopic therapy appears to result in complete cessation of bleeding.

Video Endoscopic Sequence 1 of 4.

 Rectal Dieulafoy’s lesion.

 A 62 year-old female who presented with massive
 hematochezia and who was discovered to have a
 Dieulafoy’s lesion within the rectum. was successfully
 treated with Argon Plasma Coagulator APC.

 Dieulafoy’s lesions located outside of the stomach are rare
 occurrences. Lesions found within the colon typically
 present with painless, massive hematochezia. Colonic
 Dieulafoy’s lesions are rare but should always be
 considered in the differential diagnosis of massive
 hematochezia, because endoscopic therapy appears to
 result in complete cessation of bleeding.

  Download the video clips by clicking on the endoscopic
 images, if you wish to observe in full screen, wait to be
 downloaded complete then press Alt and Enter for
 Windows media, Real Player Ctrl and 3. 
 Configure the windows media in repeat is optimal.
 All endoscopic images shown in this Atlas contain
 video clips. We recommend seeing the video clips in full
 screen mode.    

Coagulation With Argon Plasma. Urgent colonoscopy has emerged as the initial diagnostic and main therapeutic tool in the evaluation and treatment of colonic lower gastrointestinal bleeding. Endoscopic therapy can effectively treat most cases of colonic bleeding with a demonstrable improvement in clinical outcome parameters.

Video Endoscopic Sequence 2 of 4.

Coagulation With Argon Plasma.

The image as well as the video clip show retroflexed image.

 Urgent colonoscopy has emerged as the initial diagnostic
 and main therapeutic tool in the evaluation and treatment
 of colonic lower gastrointestinal bleeding. Endoscopic
 therapy can effectively treat most cases of colonic bleeding
 with a demonstrable improvement in clinical outcome
 parameters.
The identification of high-risk stigmata of hemorrhage enables selective targeting of endoscopic therapy to lesions at high risk of rebleeding. Advances in technologies such as novel mechanical methods of hemostasis (eg, metallic clips), injection techniques (eg, cyanoacrylate injection), and the widening application of established endoscopic hemostatic techniques (eg, rubber-band ligation) to colonic lesions offers the possibility of further improvements in the efficacy of endoscopic hemostasis.

Video Endoscopic Sequence 3 of 4.

 The identification of high-risk stigmata of hemorrhage
 enables selective targeting of endoscopic therapy to lesions
 at high risk of rebleeding. Advances in technologies such as
 novel mechanical methods of hemostasis (eg, metallic clips),
 injection techniques (eg, cyanoacrylate injection), and the
 widening application of established endoscopic hemostatic
 techniques (eg, rubber-band ligation) to colonic lesions
 offers the possibility of further improvements in the efficacy
 of endoscopic hemostasis.

More images and video clips of this case.

Video Endoscopic Sequence 4 of 4.

More images and video clips of this case.
Yellowish Colonic Mucosa. This is a 65 year old man with advanced rectal cancer, 18 months previously underwent surgery now presented with multiple liver metastases and obstructive jaundice.

Video Endoscopic Sequence 1 of 2.

 Yellowish Colonic Mucosa.

 This is a 65 year old man with advanced rectal cancer, 18
 months previously underwent surgery, now presented with
 multiple liver metastases and obstructive jaundice.
Yellowish Colonic Mucosa. This video clip shows the passage of feces through the descendent colon towards the rectum.

Video Endoscopic Sequence 2 of 2.

 Yellowish Colonic Mucosa.

 This video clip shows the passage of feces through the
 descendent colon towards the rectum.

 

 
Colonic Lipoma with a small hyperplastic polyp. Yellow mass was seen in the transverse colon. Lipomas are probably the commonest submucosal polyps occurring in the large bowel.

Video Endoscopic Sequence 1 of 4.

Colonic Lipoma with a small hyperplastic polyp.

 Yellow mass was seen in the transverse colon. Lipomas are
 probably the commonest submucosal polyps occurring in
 the large bowel.

  
 
They occur most commonly in the ileum, and they may be single or multiple. Duodenal lipomas are mostly small but may become pedunculated with obstruction of the lumen.

Video Endoscopic Sequence 2 of 4.

 They occur most commonly in the ileum, and they may be
 single or multiple. Duodenal lipomas are mostly small but
 may become pedunculated with obstruction of the lumen.

 
Lipomas are soft, and typically exhibit a pillow sign where a dimple is left after compression wit the tip of the biopsy forceps.

Video Endoscopic Sequence 3 of 4.

 " The Pillow Sign"

 Lipomas are soft, and typically exhibit a "pillow sign"
 where a dimple is left after compression wit the tip of the
 biopsy forceps.  

The small polyp is being removing with the biopsy forceps.

Video Endoscopic Sequence 4 of 4.

 The small polyp is being removing with the biopsy forceps.
Recto-vaginal fistula. Patient has Cervical Cancer, developed a rectovaginal fistula. The most common etiology is obstetric injury, followed by radiation injury, inflammatory bowel disease ([IBD], most often Crohn disease), operative trauma, infectious etiologies, and neoplasm.

Video Endoscopic Sequence 1 of 3.

                Recto-vaginal fistula.

 Patient has Cervical Cancer, developed a rectovaginal
 fistula.

 The most common etiology is obstetric injury, followed by
 radiation injury, inflammatory bowel disease ([IBD], most
 often Crohn disease), operative trauma, infectious
 etiologies, and neoplasm.
 
Recto-Vaginal fistula due to cervix carcinoma. Patient has colostomy in asa. Radiation used in the treatment of pelvic malignancies may result in RVF. Fistulas that occur during therapy are usually due to tumour regression. Most other fistulas become apparent 6 months to 2 years after completion of therapy. Diabetes, hypertension, smoking, and previous abdominal or pelvic surgery increase the risk of fistula formation. Differentiating radiation change at the fistula from a recurrent tumour by biopsy is imperative because neoplasms (primary, recurrent, metastatic) can produce RVFs.

Video Endoscopic Sequence 2 of 3.

 Recto-Vaginal fistula due to cervix carcinoma.
 Patient has colostomy in asa.

 Radiation used in the treatment of pelvic malignancies may
 result in RVF. Fistulas that occur during therapy are
 usually due to tumor regression. Most other fistulas
 become apparent 6 months to 2 years after completion of
 therapy. Diabetes, hypertension, smoking, and previous
 abdominal or pelvic surgery increase the risk of fistula
 formation. Differentiating radiation change at the fistula
 from a recurrent tumor by biopsy is imperative because
 neoplasms (primary, recurrent, metastatic) can produce
 RVFs.

 
The image and the video display a colonoscopy being performed from the rectum and through the colostomy.

Video Endoscopic Sequence 3 of 3.

 The image and the video display a colonoscopy being
 performed from the rectum and through the colostomy.

 For more details download the video clip.
Normal villi of the ileum. Tips of the villous projections look like dots.

Video Endoscopic Sequence 1 of 2.

 Normal villi of the ileum. Tips of the villous projections look
 like dots.
Finger-like villi are clearly observed.

Video Endoscopic Sequence 2 of 2.

 Terminal ileum.

 Finger-like villi are clearly observed.
A tablet of medicine found it in the colon. A not yet dissolved tablet was found in the descending colon that implies that the manufacturer needs to review the quality of this product.

Video Endoscopic Sequence 1 of 2.

 A tablet of medicine found it in the colon.

 A not yet dissolved tablet was found in the descending
 colon that implies that the manufacturer needs to review
 the quality of this product. 

 
Another view of this tablet.

Video Endoscopic Sequence 2 of 2.

Another view of this tablet.





 
Typhoid Fever. Intestinal hemorrhage due to a typhoid fever. The ileocecal valve and the terminal ileum are seen in the video clip. There are several tiny and bleeding ulcers. Invasion of Peyer patches occurs during either the primary intestinal infection or secondary bacteremia, and further seeding occurs through infected bile. The Peyer patches become hyperplastic with infiltration of chronically inflamed cells, which may lead to necrosis of the superficial layer and ulcer formation, with potential hemorrhage from blood vessel erosion or peritonitis from transmural perforation.

Typhoid Fever.

 Intestinal hemorrhage due to a typhoid fever.
 The ileocecal valve and the terminal ileum are seen
 in the video clip. There are several tiny and bleeding
 ulcers. 
 Invasion of Peyer patches occurs during either the primary
 intestinal infection or secondary bacteremia, and further
 seeding occurs through infected bile. The Peyer patches
 become hyperplastic with infiltration of chronically
 inflamed cells, which may lead to necrosis of the superficial
 layer and ulcer formation, with potential hemorrhage from
 blood vessel erosion or peritonitis from transmural
 perforation.  
Terminal Ileum. The terminal ileum is notable for the speckled light pattern due to the presence of villi and lymphoid nodules. This is less striking in the ileum than in the jejunum.

Terminal Ileum.

 The terminal ileum is notable for the speckled light pattern
 due to the presence of villi and lymphoid nodules. This is
 less striking in the ileum than in the jejunum.

Cervix Carcinoma that Infiltrated the Rectum. Invasive cervical cancer, The prognosis is based on the stage, size, and histologic grade of the primary tumour and the status of the lymph nodes. Assessment of the stage of disease is important in determining whether the patient may benefit from surgery or will receive radiation therapy.

Cervix Carcinoma that Infiltrated the Rectum.

 Invasive cervical cancer, The prognosis is based on the
 stage, size, and histologic grade of the primary tumor and
 the status of the lymph nodes. Assessment of the stage of
 disease is important in determining whether the patient may
 benefit from surgery or will receive radiation therapy.

Leiomyoma in the Ascending Colon. A 38 year-old woman, she had rectal bleeding for more than four months. Colonic leiomyoma is a rare condition. Smooth muscle tumours arising from the colon constitute only 3% of gastrointestinal leiomyomas.

Leiomyoma in the Ascending Colon.

 A 38 year-old woman, she had rectal bleeding for more
 than four months.

 Colonic leiomyoma is a rare condition. Smooth muscle
 tumours arising from the colon constitute only 3% of
 gastrointestinal leiomyomas.
Melena seen in colonoscopy. A 74 year-old female.This patient was hospilaized due to a gastrointestinal hemorrhage, the colonoscopy displayed melena found at the cecum.

Melena seen in Colonoscopy.

 A 74 year-old female.
 This patient was hospilaized due to a gastrointestinal
 hemorrhage, the colonoscopy displayed melena found at
 the cecum.
Bilobulated lesion that resemble an ulcerated polyp. The yellowish color resembles fibrin. two guavas seeds were found to be the cause of the lesion , as they were incrusted in the sigmoid tissue.

Video Endoscopic Sequence 1 of 3.

Guavas Seeds Incrusted in the Sigmoid

 Bilobulated lesion that resemble an ulcerated polyp.
 The yellowish color resembles fibrin. two guavas seeds
 were found to be the cause of the lesion , as they were
 incrusted in the sigmoid tissue.

   
A biopsy was performed, we noted that something hard was optained.

Video Endoscopic Sequence 2 of 3.

 A biopsy was performed, we noted that something hard was
 optained.
Some guavas seeds are observed.

Video Endoscopic Sequence 3 of 3.

 Some guavas seeds are observed.
Splecnic Angle, prominent mucosal scarring with cicatricial mucosal bridges. A small segment of the colon was observed with this pattern, no additional data was obtained, no medical history of inflammatory bowel disease.

Prominent Mucosal Scarring.

 Splecnic Angle, prominent mucosal scarring with cicatricial
 mucosal bridges. A small segment of the colon was
 observed with this pattern, no additional data was obtained,
 no medical history of inflammatory bowel disease.
    
Rectal Varix.

Video Endoscopic Sequence 1 of 2.

Rectal Varix.

 
Rectal Varix.

Video Endoscopic Sequence 2 of 2.

                  Rectal Varix
Rectal Trauma. An 82 year-old Homosexual, with severe rectal hemorrhage due to rectal trauma with blunt object.

Video Endoscopic Sequence 1 of 2.

Rectal Trauma.

 An 82 year-old Homosexual, with severe rectal hemorrhage
 due to rectal trauma with blunt object.

 
 
The hemorrhage was stopped using argon plasma coagulator.

Video Endoscopic Sequence 2 of 2.

 The hemorrhage was stopped using argon plasma
 coagulator.   

 Argon Plasma Coagulator is a new device that allows for
 non-contact monopolar coagulation of bleeding surfaces,
 and devitalization of tissue in the gastrointestinal tract. It is
 safer and much less expensive than lasers, more effective
 than bipolar cauterization techniques.

  
Colon sigmoid perforation. The image and the video display the epiplon which can be seen through the colonoscope.

Video Endoscopic Sequence 1 of 4.

Colon sigmoid perforation.

 The image and the video display the epiplon which can be
 seen through the colonoscope.
 
 
 
Colon Perforation. The image displays a bluish structure which corresponds to the spleen.

Video Endoscopic Sequence 2 of 4.

Colon Perforation.

 The image displays a bluish structure which corresponds
 to the spleen.
 

Colon Sigmoid Perforation.

Video Endoscopic Sequence 3 of 4.

Colon Sigmoid Perforation.

 

Colon Sigmoid Perforation.

Video Endoscopic Sequence 4 of 4.

               Colon Sigmoid Perforation.
 
 

A small submucous mass of the sigmoid colon is observed. A submucous balancing is done when exerting a traction with the forceps of the biopsy. In this case the endosonography would give a greater parameter in diagnosis.

 
 A small submucous mass of the sigmoid colon is
 observed.
 A submucous balancing is done when exerting a
 traction with the forceps of the biopsy.
 In this case the endosonography would give a greater
 parameter in diagnosis.

 
Tablets of medicine found it in the colon. A not yet dissolved tablets was found in the transverse colon and another one at the cecum that implies that the manufacturer needs to review the quality of this products.

Video Endoscopic Sequence 1 of 2.

 Tablets of medicine found it in the colon.
 A not yet dissolved tablets was found in the transverse
 colon and another one at the cecum that implies that the
 manufacturer needs to review the quality of this products. 

 
This tablet was found at the cecum, the video clip displays the appendicular hole.

Video Endoscopic Sequence 2 of 2.

 This tablet was found at the cecum, the video clip displays
 the appendicular hole.
This is the case of 74 year-old male, who has under screening of paraneoplastic syndrome the cat scan displays bilateral hydronephrosis with the thickening of the walls of urinary bladder and the rectum. The rectum display a cobblestone pattern , the biopsies didn't displays malignancy.

Video Endoscopic Sequence 1 of 15.

 This is the case of 74 year-old male, who has under
 screening of paraneoplastic syndrome the cat scan displays
 bilateral hydronephrosis with the thickening of the walls of
 urinary bladder and the retum.

The rectum display a cobblestone pattern , the biopsies did
not displays malignancy.

Consecutive colonoscopy with dilation was carried out. The recto-sigmoid junction has a stricture.

Video Endoscopic Sequence 2 of 15.

Consecutive colonoscopy with dilation was carried out.

The recto-sigmoid junction has a stricture.

 
Dilation with hydrostatic balloon. Hydrostatic balloon dilation is being increasingly used for gastrointestinal stenosis.

Video Endoscopic Sequence 3 of 15.

Dilation with hydrostatic balloon.

Hydrostatic balloon dilation is being increasingly used for gastrointestinal stenosis.

 
Dilation of recto-sigmoid junction.

Video Endoscopic Sequence 4 of 15.

Dilation of recto-sigmoid junction.
Hydrostatic balloon dilation of gastrointestinal stenoses

Video Endoscopic Sequence 5 of 15.

Hydrostatic balloon dilation of gastrointestinal stenosis

 
Degarro5

Video Endoscopic Sequence 6 of 15.

 
The maneuvers of the splenic angle was difficult.

Video Endoscopic Sequence 7 of 15.

The maneuvers of the splenic angle was difficult.
This image represent that some anomalies are seen in the transverse colon, the are some blood.

Video Endoscopic Sequence 8 of 15.

This image represent that some anomalies are seen in the transverse colon, the are some blood.
Colonic Tears with perforation. After the splenic angle was overcome, distantly of splenic angle in the transverse colon, we observed that something not is good; when we approached we saw that there are tears.

Video Endoscopic Sequence 9 of 15.

Colonic Tears with perforation.

 After the splenic angle was overcome, distantly of splenic
 angle in the transverse colon, we observed that something
 not is good; when we approached we saw that there are
 tears.

 
Colonic Tears with perforation. How is explained that the transverse colon was damage if the maneuvers were distantly in the splenic angle and the dilation were in the recto-sigmoid junction?. The transverse colon was fixed with the mesocolon due to the mesocolon was thickened due to the metastasis of an adenocarcinoma, disabling the normal movements of displacement forwards and backwards that are caused with the colonoscopy.

Video Endoscopic Sequence 10 of 15.

Colonic Tears with perforation.

 How is explained that the transverse colon was damage if
 the maneuvers were distantly in the splenic angle and the
 dilation were in the recto-sigmoid junction?.

 The transverse colon was fixed with the mesocolon due to
 the mesocolon was thickened due to the metastasis of an
 adenocarcinoma, disabling the normal movements of
 displacement forwards and backwards that are caused with
 the colonoscopy.

 
Colonic Tears with perforation. The patient has a large retroperitoneal mass.

Video Endoscopic Sequence 11 of 15.

Colonic Tears with perforation.

The patient has a large retroperitoneal mass.

 
Colonic Tears with perforation.

Video Endoscopic Sequence 12 of 15.

Colonic Tears with perforation.
Colonic Tears with perforation.

Video Endoscopic Sequence 13 of 15.

Colonic Tears with perforation.
Colonic Tears with perforation.

Video Endoscopic Sequence 14 of 15.

Colonic Tears with perforation.
Colonic Tears with perforation.

Video Endoscopic Sequence 15 of 15.

Colonic Tears with perforation.