August 21, 1987

Don't Be Rigid About Flexible Sigmoidoscopy

Author Affiliations

Beth Israel Hospital Boston

Beth Israel Hospital Boston

JAMA. 1987;258(7):911-912. doi:10.1001/jama.1987.03400070049027

To the Editor.—  Numerous studies1-7 have compared rigid sigmoidoscopy with flexible lower gastrointestinal endoscopy, and in most the flexible endoscopic procedure has been shown to be superior because of the greater length of bowel examined, the greater yield of pathological lesions, decreased patient discomfort, and wider physician and patient acceptance. All reports emphasize the number of lesions missed by the rigid sigmoidoscope because of its limited length and all presume that the alternative—flexible endoscopy—is as efficacious as rigid sigmoidoscopy in detecting distal lesions. We are aware of only one report8 comparing the two modalities in which a lesion that was seen with the rigid sigmoidoscope was not seen during examination by flexible sigmoidoscopy.We recently encountered two patients with synchronous colonic cancers in which one of the lesions was not detected during examination by flexible sigmoidoscopy, which was performed by an experienced endoscopist. In the first case, the