title: Method of colonoscopy in 42 consecutive patients presenting after prior incomplete colonoscopy.
abstract: OBJECTIVE
  Cecal intubation is one of the goals of colonoscopy. We sought to describe the methodology used by a single experienced examiner to perform colonoscopy in a consecutive group of patients with challenging colons.
  
  
  METHODS
  Records of 42 consecutive patients with one or more prior unsuccessful attempts at colonoscopy by a gastroenterologist or surgeon and referred for a repeat attempt at colonoscopy were reviewed.
  
  
  RESULTS
  Colonoscopy was complete to the cecum in 40 of the 42 patients (95%). An array of methods was employed, including propofol sedation (n = 2), pediatric colonoscope (n = 8), an external straightener (n = 9), external straightener with pediatric colonoscope (n = 2), upper endoscope (n = 8), guidewire exchange (n = 3), and enteroscope with a colon straightener (n = 1) or an enteroscope straightener (n = 1).
  
  
  CONCLUSIONS
  A variety of methods and instruments were employed to achieve a high cecal intubation rate during colonoscopy in a group of patients with prior incomplete colonoscopies. Others may find one or more of these methods useful in patients with challenging colons.
authors.affiliation: Indiana University Hospital, Indianapolis 46202, USA.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Rex
authors.forename: Brody W
authors.initials: BW
authors.lastname: Goodwine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002432:Cecum; D015331:Cohort Studies; D003113:Colonoscopy / Q000379:methods*; D019723:Endoscopes; D005260:Female; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged