Objective: The aim of this study is to evaluate the colonic cleansing preparation and colorectal cancer screening results in Sestao (Bilbao); and to verify the safety of endoscopist-controlled sedation. Materials and methods: A retrospective observational study of colorectal cancer screening using the immunological faecal occult blood test in a medium-risk population in this region, with colonoscopy being performed in the event of a positive result. The colonic cleansing preparation was administered in split doses; the second dose was administered 4 hours prior to colonoscopy. The quality of the preparation and lesion detection were evaluated. Sedation-related complications were analyzed. Results: Participation was high (4342 of 6896 people invited, 62.99%), with 309 subjects (7.12%) presenting a positive immunological faecal occult blood test. A high percentage of the 284 colonoscopies had optimal preparation: 276 (97.18%) had an adequate preparation. A total of 22 (7.91%) sedation-related complications were detected: only one (0.36%) was serious. A total of 140 high-risk adenomas were removed (47.13%) and 24 carcinomas were diagnosed (8.08%). Both these percentages are high. Conclusions: Split doses of colonoscopy preparation and reduction of the time interval between the second dose and the colonoscopy result in a high percentage of adequate preparation and lesion detection. Sedation by trained endoscopists is safe and effective. An immunological faecal occult blood test-based screening program is feasible and allows malignant and precancerous lesions to be efficiently detected and treated.

Colitis cystica profunda is a rare benign disease, characterized by the presence of mucin-filled cysts in the submucosa layer of colon, which forms polypoid lesions. The most habitual type of clinical presentation is localized, at distal colon or in the rectum, and more rarely appears like a diffuse afectation of colon. We present a case of colitis cystica profunda with diffuse afectation of whole colon, which definitive diagnosis was for the histological finds of the endoscopy macrobiopsys realized to colon's polypoid lesions.

Inflammatory pseudopolyps associated with inflammatory bowel disease occur on inflamed colon mucosa due to the regeneration and healing of ulcerated epithelium. They are classified as giant when they are over 1.5-cm in diameter. These are a rare, benign complication, but can be similar in appearance to colorectal cancer. It has been reported that they do not usually regress after medical treatment, requiring endoscopic resection or even surgery. In this paper, we report an unusual case with gradual regression of giant pseudopolyps with medical treatment, in a patient with inflammatory bowel disease, and another very uncommon case of a giant pseudopolyp in indeterminate colitis, with obstruction requiring surgery, as it was not possible to rule out carcinoma. A multidisciplinary team is very important.

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