patient. Narrow-band imaging can also improve outcomes with diffi-
cult patients, he says. "Certain flat and sessile polyps are easier to see.
You can demarcate what's normal colon and what's polyp. Sometimes
they're so flat, it's hard to tell the difference."
For those rare patients whose anatomies are so challenging that tradi-
tional colonoscopies are essentially impossible, the virtual colonoscopy
is an emerging technique, as is the PillCam, a small camera that patients
actually swallow. The virtual scope, which scans the abdomen in thin
layers and creates a 3D reproduction, is likely to reveal larger polyps —
those of at least 1 cm — but may not find smaller ones. "I've also seen
some false readings," says Dr. Parikh. "You go in and it turns out there's
nothing there. My assumption is that that happens because the colon
loops up, back and forth, so you have multiple parts of the colon right
next to each other." OSM
E-mail jburger@outpatientsurgery.net.
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