1222 - CASE REPORT: Colonoscopy Preparation for Spinal Cord Injury Patients: A Protocol Proposition for Improved Outcomes and Prevention of Complications.”

Case Diagnosis: Spinal Cord Injury

Case Description: The case involves a protocol to optimize preparation for colonoscopy in the spinal cord injured population.

Discussions:

Unlike respiratory or urinary issues, there is far less literature regarding the screening for colorectal cancer in SCI.  Since the procedure itself can be complicated in a patient with neurogenic bowel, many gastroenterologists may not have the expertise or experience in anticipating the complications in this population. 
Currently, there isn’t a specific CRC screening guideline for Spinal Cord Injured (SCI) patients, rather they are screened using the same guideline used in non-disabled patients but, they face many additional challenges in the regular preparation for a colonoscopy.  This oversight leaves the patients vulnerable to complications specific to the SCI population, namely autonomic dysreflexia. Due to these differences, a specific colon preparation must be considered to avoid polyps or even cancerous tumors to go unnoticed.  In this article we review an SCI patient’s case report, who was subjected to 3 colonoscopies on 3 separate occasions, with different colon preparations. 


Conclusions:

The protocols and outcomes used can serve as a model for optimizing colonoscopy preparation and potentially standardizing the practice for spinal cord injured patients.  The spinal cord injured population presents specific challenges with regards to detection and screening of colon cancer.  By following the protocol recommendations herein, complications can be avoided, and the safe performance of the colonoscopy can be performed.  With dissemination of the reliability of such a protocol, SCI patients will be able to more reliably screen for and detect potentially fatal lesions.