WHEN AND FOR WHICH PATIENTS SHOULD WE PERFORM ILEAL INTUBATION AND ILEAL BIOPSY DURING COLONOSCOPY

Remzi Akturk, Serdar Serinsoz

Abstract


Background: Terminal ileum intubation(TI) is an important part of a colonoscopy. In this study, we investigated whether patients should be selected according to their symptoms rather than taking a biopsy from all of them, or whether biopsies should be taken from patients with visual pathology only detected in the mucosa.

Material and methods: Between 2008 and 2018, patients who underwent colonoscopy and ileal biopsy in our Endoscopy Unit were investigated. We evaluated patients with right iliac fossa pain, diarrhoea, and anaemia as well as patients with a high incidence of suspected inflammatory bowel disease (IBD) and high ileal abnormality in patients undergoing colonoscopy (group A). Patients with other indications were included in another group (Group B).

Results: A total of 479 patients were planned for TI according to their symptoms and colonoscopy was performed. Both microscopic and macroscopic findings were found to be more prevalent in patients with right iliac fossa pain, diarrhoea (group A), and rectal bleeding, and significantly different from patients with other symptoms (group B) (p<0.05).

Conclusion: We recommend that patients undergoing colonoscopy with gastrointestinal complaints also undergo ileoscopy as much as possible and that blind biopsies be taken, at least in patients with symptoms suggestive of IBD even if the mucosa is macroscopically normal. The negative results we found strengthened the diagnosis of Irritable Bowel Syndrome (IBS) and made it easier for us to proceed with IBS treatment.


Keywords


Colonoscopy, ileal biopsy, ileal intubation, ileocolonoscopy, terminal ileum.

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DOI: http://dx.doi.org/10.24125/sanamed.v16i1.485

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