It is not worthwhile to perform ileoscopy on all patients

Yoong, Kevin; Heymann, T D

doi:10.1007/s00464-005-0426-9

Cited by 33 publications

(41 citation statements)

References 6 publications

(8 reference statements)

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“…In our series, only 0.3% of routine ileoscopies were illuminating, and only 0.03% of all ileoscopies detected pathology that necessitated a change in management. This is the largest series in the literature to date, and our conclusion supports those of others [4,[6][7][8]. Table 3 summarizes other literature evaluating the role of ileoscopy during colonoscopy.…”

Section: Discussionsupporting

confidence: 79%

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Routine ileal intubation during screening colonoscopy: a useful maneuver?

et al. 2008

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Section: Discussionsupporting

confidence: 79%

“…However, the utility of such an investigation is under question [4]. Patients with symptoms suggestive of inflammatory bowel disease may benefit from such an investigation, but its use for asymptomatic patients is somewhat more dubious [5].…”

mentioning

confidence: 99%

Routine ileal intubation during screening colonoscopy: a useful maneuver?

et al. 2008

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“…This is a higher figure compared to studies conducted in Western countries [2, 4, 8]. Western studies have shown a 2% to 7.2% diagnostic yield when routine TI was performed in unselected patients [5].…”

Section: Discussionmentioning

confidence: 92%

Usefulness of Routine Terminal Ileoscopy and Biopsy during Colonoscopy in a Tropical Setting: A Retrospective Record-Based Study

Wijewantha

Silva

Niriella

et al. 2014

Gastroenterology Research and Practice

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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.

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“…26 The differential diagnosis for abnormal endoscopic and histologic findings in the terminal ileum of patients with acute or chronic diarrhea includes Crohn's disease, NSAID-induced enteropathy, carcinoid, tuberculosis, lymphoma, and adenocarcinoma. 14,27,28 In a prospective evaluation of 138 patients, ileoscopy provided additional information leading to an incidental, conclusive diagnosis in 2.7% of asymptomatic patients undergoing colonoscopy for polyp surveillance; the rate increased to 18% in 22 non-human immunodeficiency virus (HIV) patients with diarrhea. 29 Terminal ileal biopsy is most helpful in patients with or suspected of having inflammatory diarrhea.…”

Section: Colonoscopymentioning

confidence: 99%