[Emergency colonoscopy in the diagnosis and treatment of acute colorectal obstruction].

Objective: To assess the application value of emergency colonoscopy in the diagnosis and treatment of acute colorectal obstruction.

Methods: A total of 459 patients with acute colorectal obstruction received emergent colonoscopy from July 2002 to July 2010. The safety and effective rates were analyzed.

Results: The diagnostic rate of successful emergency colonoscopy was 100% (459/459) without any complication. Colorectal cancer were found in 71.3% cases (327/459), volvulus of sigmoid in 11.3% (52/459), diaphragmatocele in 0.4% (2/459), megacolon congenitum in 0.6% (3/459), fecal obstruction in 2.7% (12/459) and none in 13.7% (63/459). The therapeutic rate of colonoscopy was 83.2% (385/459). There were colorectal cancer (n = 327), volvulus of sigmoid (n = 52) and megacolon congenitum (n = 3). The successful treatment rate was 95.8% (369/385) and the complication rate 1.4% (5/385). Among all colorectal cancers, 93.9% (307/327) received endoscopic drainage (mental stents or drainage tube) so as to avoid emergency operations and stoma. And 232 cases underwent phase I operation and another 75 cases received chemotherapy or supportive treatment.

Conclusion: Emergency colonoscopy is an effective, safe, minimal invasive approach for diagnosing and managing acute colorectal obstruction.