SCENIC Endoscopic Classification | EndoCollab
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Clinical Education Series
SCENIC Endoscopic Classification
Simplifying the identification of superficial colorectal dysplasia in IBD patients using the Paris consensus.
Pedunculated
Paris Ip
Lesion attached by a distinct stalk. High visibility, usually easily resectable.
Resection: Standard Snare Polypectomy. Low risk of missed margins.
Sessile
Paris Is
Broad-based attachment without a stalk. Standard snare resection indicated.
Resection: Hot or Cold Snare. Lift may be required for larger lesions.
Slightly Elevated
Paris IIa
Subtle mucosal elevation (typically < 2.5mm). Requires careful border inspection.
Resection: EMR (Endoscopic Mucosal Resection) preferred.
Completely Flat
Paris IIb
Flush with surrounding mucosa. Often identified via chromoendoscopy.
Detection: Use Dye-based or Virtual Chromoendoscopy (NBI/LCI).
Depressed
Paris IIc
Central depression relative to margins. High risk for submucosal invasion.
Warning: Higher risk of T1 cancer. Consider ESD (Endoscopic Submucosal Dissection).
Ulceration
Present or Absent. Deep ulceration is a sign of aggressive behavior or advanced disease.
Ulceration is a strong predictor of non-resectability (Surgery indicated).
Border
Distinct vs Indistinct. Essential for determining endoscopic resectability.
Indistinct borders may require random biopsies of the surrounding mucosa.
SCENIC DESCRIPTORS
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