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KMID : 0876320000020010029
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Cachon Medical Journal
2000 Volume.2 No. 1 p.29 ~ p.36
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The Clinical Significance of Colonoscopy in Patients with Benign Anorectal Disease
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Oh Jae-Hwan
Park Hyun-Chul
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Abstract
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Purpose: Benign anorectal disease will often cause great phobia to the patient and practitioner of harboring a more proximal colon pathology. The aim of this study is to evaluate the significance of routine investigation of colonoscopy in patient of benign anorectal disease.
Materials and Methods: Retrospective analysis was done in 108 patients with benign anorectal disease who were underwent colonoscopic investigation from April 1997 to August 1998 at Gil Medical Center.
Results: The mean age of all patients was 43 years; male to female ratio was 1:1.1. The diagnoses of anorectal disease were hemorrhoid in 84 cases, anal fissure in 13 cases, chronic anal pain syndrome in 6 cases, anorectal fistula in 5 cases, others in 9 cases. There were 37 patients (34.3%) with 53 abnormal findings which were 14 tubular adenomas, 11 inflammatory polyps, 4 hyperplastic polyps, 1 tuberculous colitis, 1 angiodysplasia, 6 diverticula, 6 nonspecific ileitis or colitis, 2 melanosis coli, 2 rectal ulcer, 2 ileal ulcer and 3 other diseases. Among them clinically significant lesions which were neoplastic lesion, tuberculous colitis and angiodysplasia were detected in 12 patients (11.1%) and within the reach of sigmoidoscopy in 7 patients. So 5 patients (4.6%) were needed for colonoscopic investigation. In regard to neoplasm, patients presenting with anal bleeding and old age were not found to have higher detection of neoplasia and the specific type of anorectal disease present was not associated with an increased risk for colorectal neoplasia (P > 0.05).
Conslusion: The risk of colorectal neoplasia in patient with benign anorectal disease does not appear greater than that in general population. Sigmoidoscopy is more acceptable primary diagnostic tool in patients with benign anorectal disease, but in patients with gastrointestinal symptom, high risk factor for colorectal cancer, suspicious inflammatory bowel disease or cancer phobia, selective colonoscopy was needed.
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KEYWORD
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Benign Anorectal disease, Colonoscopy
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