ILEOSCOPY

DIAGNOSTIC YIELD IN A TERTIARY CARE HOSPITAL OF PAKISTAN

Abstract

Colonoscopy is one of the most important modalities to investigate complaints
related to lower gastrointestinal tract. Terminal ileum is an essential part of the complete
colonoscopic examination. Objectives: To observe the diagnostic yield of ileoscopy in patients
undergoing colonoscopy. Design: Retrospective and observational study. Period: January 2010
to May 2014. Setting: Liaquat National Hospital and Medical College. Patients and methods:
Patients undergoing colonoscopy fulfilling inclusion and exclusion criteria were enrolled.
Terminal ileum was examined and biopsies taken if abnormality present. Statistical analysis
was done by SPSS- 18. Result: A total of 1296 patients were included, 884 (68.2%) were male
and 412 (31.8%) were female. Age ranged from 15-90 years. The commonest indication was
bleeding per rectum (35.6%).1133(87.4%) patients had normal mucosa and 163 (12.6%) had
abnormal mucosa on ileoscopy. Of these 163 patients, 68 had ulcers, 56 had inflammation, 29
had nodular mucosa and 10 had polyp. Histopathological examination showed non-specific
inflammation in 139 patients; granulomatous inflammation in 7; reactive lymphoid hyperplasia
in 8; 3 had normal result; biopsies were not taken in remaining 6 patients. By using chi-square
test we found a significant statistical relationship between macroscopic abnormality of terminal
ileum mucosa and age of patients, weight loss, chronic diarrhoea, and abdominal pain. On
logistic regression, age group, chronic diarrhoea and weight loss retained strong relationship
with macroscopic abnormality of terminal ileum mucosa. Conclusions: Though a large number
of patients (12.6%) had abnormal terminal ileum mucosa, histopathological analysis did not
show any significant yield of ileoscopy. Terminal ileal abnormality was more common in young
and middle aged patients and in patients presenting primarily with chronic diarrhoea and
weight loss.