Please use this identifier to cite or link to this item: http://repository.kln.ac.lk/handle/123456789/2363
Title: Usefulness of routine terminal ileoscopy and biopsy during colonoscopy in a tropical setting: a retrospective record-based study
Authors: Wijewantha, H.S.
de Silva, A.P.
Niriella, M.A.
Wijesinghe, N.
Waraketiya, P.
Kumarasena, R.S.
Dassanayake, A.S.
Hewavisenthi, S.J.de S.
de Silva, H.J.
Issue Date: 2014
Publisher: Hindawi Publishing Corporation
Citation: Gastroenterology Research and Practice. 2014; 2014:343849
Abstract: Introduction. Available evidence for routine terminal ileoscopy during colonoscopy is equivocal. We investigated the place of routine terminal ileoscopy and biopsy during colonoscopy, in a tropical setting. Materials and Methods. All consenting adults undergoing colonoscopy had routine TI and biopsy. Patients with right iliac fossa (RIF) pain, diarrhoea, anaemia, suspected inflammatory bowel disease (IBD), and raised inflammatory markers were defined as Group A and all others undergoing colonoscopy as Group B. Results. Caecal intubation and TI were achieved in 988/1096 (90.15%) and 832/1096 (75.9%) cases, respectively. 764/832(91.8%) patients were included in final analysis. 81/764 (10.6%) patients had either macroscopic (34/81) or microscopic (47/81) abnormalities of terminal ileum; 20/81 had both. These were CD (28/47), tuberculosis (TB) (6/47), ileitis due to resolving infection (8/47), and drug-induced ileitis (5/47). 27/81 with macroscopically normal ileum had CD (18/27), ileitis due to resolving infection (5/27) and drug-induced ileitis (4/27) on histology. 12/764 (1.57%) patients with macroscopically normal colon had ileal CD (8/12), drug-induced ileitis (2/12), and resolving ileal infection (2/12) on histology. 47/764 (6.15%) patients had ileal pathology that influenced subsequent management. These were significantly higher in Group A (43/555 (8%)) than in Group B (4/209 (1.9%)) (P = 0.0048, χ (2) = 7.968). Conclusion. TI and biopsy improve diagnostic yield of colonoscopy in patients with RIF pain, diarrhoea, anaemia, suspected IBD, and raised inflammatory markers.
URI: http://repository.kln.ac.lk/handle/123456789/2363
ISSN: 1687-6121 (Print)
1687-630X (Electronic)
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