CPT® Code 45321

A rigid proctosigmoidoscopy is a diagnostic and therapeutic procedure that involves the examination of the rectum and the lower part of the sigmoid colon using a rigid scope. This procedure is specifically performed to address a condition known as volvulus, which is characterized by the twisting of the intestines, leading to an obstruction. The procedure begins with the insertion of an obturator into the proctosigmoidoscope, which is then introduced into the anus and advanced approximately 5 centimeters into the rectum. Once the scope is in position, the obturator is removed, and an eyepiece is attached to allow for visualization. The scope is then advanced further into the rectum towards the site of the volvulus, utilizing air insufflation to gently separate the mucosal folds for better visibility. During the examination, the mucosa is meticulously inspected for any signs of ischemia or necrosis, which could indicate compromised blood flow or tissue death. If the mucosa appears to be healthy, a rectal tube is then passed beyond the twisted segment of the intestine to relieve the obstruction by allowing gas and stool to be expelled. After the procedure, the scope is removed, and the rectal tube is secured in place at the perianal region, where it is typically left in position for a duration of 48 hours to ensure proper drainage and monitoring of the condition.