Is ileocecal valve intubation essential for routine colonoscopic examination?

• Published in: European journal of gastroenterology & hepatology Vol. 30; no. 4; p. 432
• Main Authors: Meral, Murat, Bengi, Göksel, Kayahan, Hasan, Akarsu, Mesut, Soytürk, Müjde, Topalak, Ömer, Akpinar, Hale, Sağol, Özgül
• Format: Journal Article
• Language: English
• Published: England 01.04.2018
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Biopsy; Colonic Diseases - diagnosis; Colonoscopy - methods; Conscious Sedation - methods; Crohn Disease - diagnosis; Endoscopy, Gastrointestinal - methods; Female; Humans; Ileal Diseases - diagnosis; Ileal Diseases - pathology; Ileocecal Valve; Ileum - pathology; Male; Middle Aged; Prospective Studies; Sex Factors; Time Factors; Young Adult
• ISSN: 1473-5687
• 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.