Table 2.
Recommended images of landmarks in colonoscopy
| Recommendations | Terminal ileum | Colon | Rectum | Anal canal perianal area | |
|---|---|---|---|---|---|
| ESGE [1] (2001) | – | Cecum and appendiceal orifice Ileocecal valve Ascending colon under the hepatic flexure Transverse colon just distal to the hepatic flexure Transverse colon just proximal to the splenic flexure Descending colon below the splenic flexure Middle part of the sigmoid |
Lower part of the rectum (taken 2 cm above the anal line) | – | |
| ASGE/ACG/AGA/AMA [2] (2008) | – | Cecum, appendiceal orifice, and ileocecal valve | – | – | |
| ESGE [3] (2012) | Optional (if intubated) | Cecum and appendiceal orifice (taken from a distance of 2–4 cm to encompass the cecal strap fold) Cecum and ileocecal valve Ascending colon under the hepatic flexure Transverse colon just distal to the hepatic flexure Transverse colon just proximal to the splenic flexure Descending colon below the splenic flexure Middle part of the sigmoid* |
Lower part of the rectum in both forward (taken 2 cm above the anal line) and retroflexed views | – | |
| WCOG 2013 Working Party Report [5] (2014) | Optional (in alternative to cecal landmarks) | Cecum and appendiceal orifice Ileocecal valve The least cleansed of the three colonic segments |
Optional (retroflexed view if performed) | – | |
| ASGE/ACG/ AGA [6, 8] (2015) | Optional (in alternative to cecal landmarks) | Cecum, appendicular orifice, and cecal strap fold Cecum and ileocecal valve |
Rectum in retroflexed view | – | |
| Tang et al. [9] (2015) | Optional (if intubated) | Cecum, appendiceal orifice, and ileocecal valve Ascending colon Transverse colon Descending colon Sigmoid colon |
Rectum in both forward and retroflexed views | Optional (if they are relevant to the presenting symptoms) | |
*
In cases in which procedures are aborted because of poor preparation or severe colitis, photo documentation should be provided to support the decision to abort the examination.