PTU-6 Completion colonoscopy in patients with adenomas identified on flexible sigmoidoscopy; is it always necessary?

Assessing Guidelines on the Need for Colonoscopy after Initial Flexible Sigmoidoscopy in Young Patients with Outlet-Type Rectal Bleeding

“…Several other groups have reported the findings of colonoscopy performed in patients with outlet-type rectal bleeding, some limiting their studies to young patients. Good et al provided a small study that seems to agree with our conclusions, 22 whereas earlier reports by Eckardt et al 30 and Carlo et al 31 found a very low risk of proximal neoplasia in similar groups of patients. Koh et al 32 found that within the group of patients younger than 50 years, patients in their 40s with outlet-type rectal bleeding were at a higher risk of colorectal neoplasia than those who were younger, making the case for colonoscopy, at least in this older subgroup.…”

“…20 The role of SSLs and serrated polyposis in colorectal neoplasia has been appreciated relatively recently and certainly postdates the study by Atkin et al 19,20 Our guidelines combine definitions of HRLs by Atkin et al with high-risk serrated lesions into a set of criteria that, when found on FS, would mandate follow-up colonoscopy (Table 1). 21 Good et al 22 tested these guidelines in a small study in which 29 patients had a colonoscopy after their FS. Only 1 patient younger than 60 years had a high-risk lesion at colonoscopy and that patient also had an HRL at FS.…”