Abstracto

Retroflexion in the proximal colon in the evaluation and resection of large nonpedunculated polyps.

Goncalo Alexandrino, Lu

We present the case of a piecemeal endoscopic mucosal resection of a 40 mm flat lesion of the proximal ascending colon. On the follow-up colonoscopy there was residual lesion which seemed to be not totally visible in direct vision. Retroflexion of the colonoscope was crucial to better characterize the lesion and perform submucosal injection, thus making endoscopic mucosal resection in direct vision effective. Retroflexion in colonoscopy is commonly used for rectal lesions. However, as shown in this case, it can be a very useful technique in the proximal colon to detect lesions that otherwise would not be visible or resect lesions that are difficult to access in the forward view. In conclusion, retroflexion in the proximal colon is simple to perform, safe and can be very useful in the evaluation and resection of lesions with difficult approach in direct vision.