Category: Endoscopy
Aims: Terminal ileal intubation is not routinely performed by surgeons because of difficulties with technique, time and a low diagnostic yield. The aim of this study is to assess the role of terminal ileal intubation during colonoscopy and its impact on patient management.
Methods: This is a retrospective analysis of colonoscopies performed within a colorectal surgery unit over a 10 month period. All procedures were performed by a surgical trainee. Terminal ileal intubations were accompanied by biopsies unless contraindicated.
Results: A total of 172 colonoscopies were performed. 139 complete colonoscopies and 33 incomplete colonoscopies. 6 patients were excluded because they had previously had right colectomies. Caecal intubation was achieved in 133 procedures (88.1%) and ileal intubation in 69 procedures (51.9%). The visualised ileal mucosa appeared endoscopically normal in all cases. In 92.8% of cases, the terminal ileal mucosa was biopsied and these were histologically normal.
Conclusions: Terminal ileal intubation appears not to be necessary following a complete colonoscopy as its low diagnostic yield rarely impacts on the patient management. It appears that its main role is to provide histological confirmation of a complete colonoscopy, however it may be specifically indicated in Crohn's disease.
