Chromoendoscopy

Updated: Sep 14, 2017
  • Author: Kondal Rao Kyanam Kabir Baig, MD; Chief Editor: Kurt E Roberts, MD  more...
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Overview

Background

Chromoendoscopy is an endoscopic technique that uses stains during endoscopy to highlight differences in mucosa, as well as dysplastic and malignant changes that are not apparent in white light. Chromoendoscopy is used to increase the detection rates for various pathologic processes during endoscopy. Chromoendoscopy is often used in surveillance of the esophagus for Barrett esophagus, evaluation of polyps in the colon, and surveillance of dysplasia in inflammatory bowel disease (IBD). [1, 2]

Initial evaluations of computerized virtual chromoendoscopy for screening colonoscopy showed efficacy similar to that of chromoendoscopy, without the logistical difficulties or preparing and applying vital dyes. [3, 4]  Magnification endoscopy, spectroscopy, confocal laser endomicroscopy and endocytoscopy have important roles in the evaluation of IBD and surveillance of chronic ulcerative colitis (UC). [5, 6, 7]  Use of these techniques in Barrett esophagus has also led better detection of dysplasia, particularly in the absence of discrete lesions. [8]

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Indications

Chromoendoscopy has been used in the evaluation of Barrett esophagus, [9, 10, 11]  esophageal adenocarcinoma, [12]  gastric metaplasia and adenocarcinoma, [13, 14, 15, 16]  colon polyps, [17, 18]  colon cancer, [19, 20, 21, 22, 23]  and surveillance in IBD. [24]

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Contraindications

The contraindications to chromoendoscopy would be any of the usual contraindications to endoscopy or a history of an allergic reaction to the dye or stain used in the specific clinical situation.

Chromoendoscopy is not routinely performed during general endoscopy. It is performed in centers that specialize in this field or on a case-by-case basis as indicated by the clinical situation and dictated by the experience of the endoscopist and the center.

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