Meral Murat, Bengi Göksel, Kayahan Hasan, Akarsu Mesut, Soytürk Müjde, Topalak Ömer, Akpinar Hale, Sağol Özgül
Departments of Gastroenterology.
Pathology, Dokuz Eylul University Faculty of Medicine, İzmir, Turkey.
Eur J Gastroenterol Hepatol. 2018 Apr;30(4):432-437. doi: 10.1097/MEG.0000000000001065.
In this study, we aimed to assess the diagnostic yield of terminal ileum intubation during routine colonoscopy.
We routinely performed terminal ileum intubation in all patients who underwent colonoscopy at Dokuz Eylul University Hospital between February 2014 and June 2015. Two gastroenterology fellows performed colonoscopies in the Central Endoscopy Unit. Demographic data of patients, indications of colonoscopies, cecum and ileum intubation rate/time, and endoscopic and histopathologic findings of the terminal ileum were all assessed.
A total of 1310 consecutive patients (726 female and 584 male, median age: 55.79±14.29 years) underwent colonoscopy during this study period. The colonoscopy was successfully completed in 1144 (87.3%) cases. The terminal ileum was successfully intubated in 1032 (90.2%) cases. The mean time taken to reach the ileum from the cecum was 63.08±64.16 s. Endoscopic abnormalities on the terminal ileum were present in 62 (6%) cases, and biopsies were taken from these patients. However, endoscopic abnormalities were found in 7 and 3.3% of patients who were symptomatic and asymptomatic, respectively. There were statistically significant differences between symptomatic and asymptomatic patients (P=0.02). Clinically significant histopathologic findings were observed in 22 cases, and 12 of the 22 cases were diagnosed as having Crohn's disease.
Terminal ileum intubation is particularly indicated in symptomatic patients. In cases of chronic diarrhea, iron-deficiency anemia, abdominal pain, and suspected inflammatory bowel disease, terminal ileum intubation should be done.
在本研究中，我们旨在评估常规结肠镜检查期间回肠末端插管的诊断率。
2014年2月至2015年6月期间，在多库兹艾吕尔大学医院对所有接受结肠镜检查的患者常规进行回肠末端插管。两名胃肠病学进修医生在中央内镜室进行结肠镜检查。评估患者的人口统计学数据、结肠镜检查指征、盲肠和回肠插管率/时间，以及回肠末端的内镜和组织病理学检查结果。
在本研究期间，共有1310例连续患者（726例女性和584例男性，中位年龄：55.79±14.29岁）接受了结肠镜检查。1144例（87.3%）患者成功完成结肠镜检查。1032例（90.2%）患者成功进行了回肠末端插管。从盲肠到达回肠的平均时间为63.08±64.16秒。62例（6%）患者回肠末端存在内镜异常，并对这些患者进行了活检。然而，有症状和无症状患者中分别有7%和3.3%发现内镜异常。有症状和无症状患者之间存在统计学显著差异（P = 0.02）。22例观察到具有临床意义的组织病理学检查结果，其中22例中有12例被诊断为克罗恩病。
回肠末端插管特别适用于有症状的患者。对于慢性腹泻、缺铁性贫血、腹痛和疑似炎症性肠病的病例，应进行回肠末端插管。
