Terminal Ileal Intubation: Interest and Results, through 5224 Ileo-Colonoscopies

Abstract

Introduction: Ileo-colonoscopy is considered the method of choice for exploring the terminal ileum. However, the diagnostic value of terminal ileal intubation (IBD) during colonoscopy remains controversial. The objective is to evaluate the frequency, the interest and the results of systematic catheterization of the IBD with biopsies during a total colonoscopy. Patients and Methods: Were included all patients referred to the service for a colonoscopy whatever the indication from July 2006 to July 2022; in whom IBD catheterization was performed whenever possible regardless of the indication for colonoscopy. All colonoscopies were performed under Propofol sedation and all patients were prepared with Polyethylene Glycol (PEG). Results: Out of a total of 5224 colonoscopies, the IBD was catheterized in 2371 patients, i.e. a frequency of 45%. 62% were men and 37% women. The average age was 46 years old. The most common indications were diarrhea in 35% patients and rectal bleeding in 30% patients. IBD was abnormal in 249 patients (11%): congestive ileitis in 88 patients (3.7%), nodular ileitis in 75 patients (3.1%), ulcerated ileitis in 72 patients (3%), stenosis in 10 patients (0.5%), an ulcero-budding tumor in 2 patients (0.1%) and angiodysplasia in 2 patients (0.1%).The histological study of ileal biopsies was pathological in 116 patients (47%): Crohn's disease in 110 patients (94.8%), tuberculosis in 4 patients (3.4%), radiation ileitis in 1 patient (0.8%) and neuroendocrine carcinoma in 1 patient (0.8%). Conclusion: The diagnostic yield of catheterization of the last ileal loop varies according to the indications for colonoscopy. It should be done as often as possible during each colonoscopy to objectify terminal ileitis most often referred to Crohn's disease and therefore requiring adequate medical care.