Emami Mohammad Hasssan, Behbahan Iman Saramipoor, Zade Hamed Daghagh, Daneshgar Hoshang
Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2009 May;14(3):157-63.
Lower digestive endoscopy is mostly limited to the cecum without any attempt to penetrate the ileum. One of the probable reasons is the expectation of a low diagnostic yield. This study aimed to examine the feasibility of ileoscopy during colonoscopy and its diagnostic yield.
We prospectively studied 128 consecutive patients, who were referred to Poursina Hakim Research Institute for lower GI disorders evaluation over a four months period, from March to July 2003. We tried to do total colonoscopy and ileal intubation with special attention to the timing and success rate of colonoscopy in each landmark.
Out of 128 subjects, successful examination of cecum was done in 120 (93.6%). Out of 120 patients whose cecum was reached and studied, we intended to perform ileal intubation in 99 patients. Successful terminal ileal (TI) intubation was accomplished in 93(93.9 %) of the examinations. Abnormal findings were seen in 4 cases. Normal ileal findings were also helpful in ruling out TI pathology in 78 other patients with abdominal pain, weight loss, lower GI bleeding or colonic inflammation, which made ileoscopy clinically valuable in 82 of 95 normal ileal examinations (86.3%) in this study.
Ileoscopy is safe, fast and feasible, so we recommend it in all symptomatic cases since normal findings are also valuable in patients' clinical management. Considering normal findings, the routine ileoscopy had surprisingly higher diagnostic yield compared to the results of previous studies.
下消化道内镜检查大多局限于盲肠，未尝试进入回肠。可能的原因之一是预期诊断率较低。本研究旨在探讨结肠镜检查时进行回肠镜检查的可行性及其诊断率。
我们前瞻性地研究了128例连续患者，这些患者在2003年3月至7月的四个月期间被转诊至普尔西纳·哈基姆研究所评估下消化道疾病。我们尝试进行全结肠镜检查和回肠插管，并特别关注每个标志点结肠镜检查的时机和成功率。
128例受试者中，120例（93.6%）成功检查了盲肠。在120例到达并检查了盲肠的患者中，我们打算对99例患者进行回肠插管。93例（93.9%）检查成功完成了末端回肠（TI）插管。4例发现异常。正常的回肠检查结果也有助于排除另外78例腹痛、体重减轻、下消化道出血或结肠炎症患者的TI病变，这使得在本研究中95例正常回肠检查中的82例（86.3%）回肠镜检查具有临床价值。
回肠镜检查安全、快速且可行，因此我们建议在所有有症状的病例中进行，因为正常结果在患者的临床管理中也很有价值。考虑到正常结果，常规回肠镜检查的诊断率与先前研究结果相比出人意料地更高。
