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Gastroenterology Research and Practice
Volume 2014 (2014), Article ID 343849, 5 pages
http://dx.doi.org/10.1155/2014/343849
Research Article

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

1University Medical Unit, Colombo North Teaching Hospital, 11010 Ragama, Sri Lanka
2Department of Medicine, Faculty of Medicine, P.O. Box 06, Thalagolla Road, 11010 Ragama, Sri Lanka
3Department of Pharmacology, Faculty of Medicine, University of Kelaniya, 11010 Ragama, Sri Lanka
4Department of Pathology, Faculty of Medicine, University of Kelaniya, 11010 Ragama, Sri Lanka

Received 27 October 2013; Revised 14 December 2013; Accepted 15 December 2013; Published 16 January 2014

Academic Editor: Sergio Morini

Copyright © 2014 Hasitha Srimal Wijewantha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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%)) ( , ). Conclusion. TI and biopsy improve diagnostic yield of colonoscopy in patients with RIF pain, diarrhoea, anaemia, suspected IBD, and raised inflammatory markers.