Abstract

CASTANO LLANO, Rodrigo et al. Role of routine ileal intubation during the colonoscopy. Rev Col Gastroenterol [online]. 2008, vol.23, n.3, pp.240-249. ISSN 0120-9957.

Background: During colonoscopy ileal intubation does not have a specific indication; neither is it accepted as a routine procedure. Objectives: To determine the possible association among ileal intubation, with the antecedents and the indications of the colonoscopy and those with the endoscopic findings. Patient and Methods: This is a descriptive-retrospective study in which the results of the colonoscopies of 2202 patients were evaluated with (1467 patients 67%) and without ileoscopy carried out in a hospital of fourth level during April from 2004 to March of 2006. Results: The main indications of the colonoscopy were abdominal pain (46%), rectal bleeding (22%) and diarrhea (11%). The logistical simple and multivariate analysis allowed to predict a more frequent use of ileal intubation in patients younger than 50 years, presence of abdominal pain, diarrhea or follow-up of Inflammatory Bowel Disease (IBD); all these were significant variables. More frequents findings in ileal intubation were: erosions (50%) and ulcers (40%). Overall, the terminal ileum was abnormal in 72 of 1467 patients (5%) There were a significant association between the ileoscopic findings and antecedents as: consumption of AINEs (p < 0.001), HIV (p < 0.001), and indications like: abdominal pain (p < 0.005, IC 95%: 1.2-3.3, OR of 2), diarrhea (p < 0.001 IC 95%: 5.8-15.6, OR of 9.5) and follow-up of IBD (p < 0.001 IC 95%: 3.2-9.6, OR of 5.6). Conclusions: Ileal intubation is a procedure that offers a bigger diagnostic possibility in a group of patient with some indications and specific antecedents. Further study is required to determine whether terminal ileum examination impacts patient management or outcome.

Keywords : Colonoscopy; ileal intubation; HIV; Chronic diarrhoea; inflammatory bowel disease.

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