ILEOSCOPY

Abstract

Colonoscopy is one of the most important modalities to investigate complaintsrelated to lower gastrointestinal tract. Terminal ileum is an essential part of the completecolonoscopic examination. Objectives: To observe the diagnostic yield of ileoscopy in patientsundergoing colonoscopy. Design: Retrospective and observational study. Period: January 2010to May 2014. Setting: Liaquat National Hospital and Medical College. Patients and methods:Patients undergoing colonoscopy fulfilling inclusion and exclusion criteria were enrolled.Terminal ileum was examined and biopsies taken if abnormality present. Statistical analysiswas done by SPSS- 18. Result: A total of 1296 patients were included, 884 (68.2%) were maleand 412 (31.8%) were female. Age ranged from 15-90 years. The commonest indication wasbleeding per rectum (35.6%).1133(87.4%) patients had normal mucosa and 163 (12.6%) hadabnormal mucosa on ileoscopy. Of these 163 patients, 68 had ulcers, 56 had inflammation, 29had nodular mucosa and 10 had polyp. Histopathological examination showed non-specificinflammation in 139 patients; granulomatous inflammation in 7; reactive lymphoid hyperplasiain 8; 3 had normal result; biopsies were not taken in remaining 6 patients. By using chi-squaretest we found a significant statistical relationship between macroscopic abnormality of terminalileum mucosa and age of patients, weight loss, chronic diarrhoea, and abdominal pain. Onlogistic regression, age group, chronic diarrhoea and weight loss retained strong relationshipwith macroscopic abnormality of terminal ileum mucosa. Conclusions: Though a large numberof patients (12.6%) had abnormal terminal ileum mucosa, histopathological analysis did notshow any significant yield of ileoscopy. Terminal ileal abnormality was more common in youngand middle aged patients and in patients presenting primarily with chronic diarrhoea andweight loss.