Terminal ileum of patients who underwent colonoscopy: endoscopic, histologic and clinical aspects.
BACKGROUND
For the diagnosis of the diseases which affect the terminal ileum, the colonoscopy allows macroscopic evaluation and the performing of biopsies. Studies with criteria for the endoscopic and histological characterization of this segment are scarce and there are still some doubts about the need of biopsies in patients with normal ileoscopy.


OBJECTIVE
Study the terminal ileum of patients who underwent colonoscopy considering: endoscopic and histological correlation; agreement between results of the initial histological evaluation and slides review, and the chance of subjects with normal ileoscopy with abdominal pain and/or chronic diarrhea to show histological alterations.


METHODS
In a prospective study, 111 patients who presented smooth mucosa without enanthema in the endoscopic exam of the terminal ileum were selected. Biopsies of the ileal mucosa of such patients were performed, being the slides routinely examined and reviewed afterwards.


RESULTS
The correlation between patients with normal ileoscopy and ileum with preserved histological architecture was of 99.1%. The agreement between initial histological evaluation and slides review calculated by the Kappa test was 0.21. In patients with abdominal pain and/or chronic diarrhea, the chance of showing histological alterations was 2.5 times higher than the others.


CONCLUSIONS
The correlation between endoscopic and histological findings was high. The agreement between the initial histologic evaluation and slides review was not satisfactory. The chance of subjects with normal ileoscopy with abdominal pain and/or chronic diarrhea, showing histological alterations was higher in relation to the asymptomatic ones or with other symptoms, although the clinical importance of this datum was not evaluated.
Melo
Marcelo Maia Caixeta de
MM
Surgery Department, Medical School of São José do Rio Preto, São Paulo, Brazil. maiacaixeta@ig.com.br
Cury
Patrícia Maluf
PM
Ronchi
Luiz Sérgio
LS
Gonçalves-Filho
Francisco de Assis
Fde A
Cunrath
Geni Satomi
GS
Netinho
João Gomes
JG
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002908:Chronic Disease; D003967:Diarrhea / Q000209:etiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000473:pathology*; D007082:Ileum / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult