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Diagnostic value of terminal ileum intubation during colonoscopy.

Authors
Jeong, SH; Lee, KJ; Kim, YB; Kwon, HC; Sin, SJ; Chung, JY
Citation
Journal of gastroenterology and hepatology, 23(1):51-55, 2008
Journal Title
Journal of gastroenterology and hepatology
ISSN
0815-93191440-1746
Abstract
BACKGROUND AND AIM: Since the diagnostic value of ileoscopy is not well documented, it is uncertain if terminal ileum intubation should be performed routinely in patients undergoing colonoscopy. We aimed to assess the diagnostic yield of terminal ileum intubation during colonoscopy according to indications for colonoscopy. METHODS: We routinely performed terminal ileum intubation in subjects who underwent colonoscopy at Ajou University Hospital between 1 January 2005 and 31 December 2005. Demographic data, indications for colonoscopy, endoscopic, and histopathologic findings of the terminal ileum were assessed. RESULTS: A total of 3921 subjects underwent colonoscopy. The terminal ileum was successfully intubated in 3417 cases (87.1%). Macroscopic abnormality on terminal ileum was present in 125 cases (3.7%), and biopsies were taken for all of them. Clinically significant histopathology was observed in 11 cases, giving a 0.3% diagnostic yield in all ileoscopies. Seven out of 11 cases were diagnosed as Crohn's disease. The rate of diagnostic yield was 1.8% in patients with right lower quadrant (RLQ) abdominal pain and 0.4% in patients with diarrhea. This rate in cases with RLQ pain was significantly greater compared with the indications for medical check-ups. CONCLUSIONS: Terminal ileum intubation during colonoscopy identifies significant pathology in 1.8% of cases who have RLQ abdominal pain, suggesting diagnostic value in this setting. However, its diagnostic yield is very low in other indications for colonoscopy. Thus the decision to perform ileoscopy or not during colonoscopy needs to be made on a case-by-case basis.
MeSH terms
AdultAgedColonic Diseases/diagnosis*Colonoscopy/methods*Crohn Disease/diagnosisEndoscopy, GastrointestinalFemaleHumansIleal Diseases/diagnosis*Ileum*MaleMiddle AgedProspective Studies
DOI
10.1111/j.1440-1746.2007.05151.x
PMID
18171342
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Journal Papers > School of Medicine / Graduate School of Medicine > Hematology-Oncology
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Journal Papers > School of Medicine / Graduate School of Medicine > Pharmacology
AJOU Authors
정성현이광재김영배권혁춘신성재정재연
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