title: Terminal ileum of patients who underwent colonoscopy: endoscopic, histologic and clinical aspects.
abstract: 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.
authors: Surgery Department, Medical School of São José do Rio Preto, São Paulo, Brazil. maiacaixeta@ig.com.br
authors: Marcelo Maia Caixeta de
authors: MM
authors: Melo
authors: Patrícia Maluf
authors: PM
authors: Cury
authors: Luiz Sérgio
authors: LS
authors: Ronchi
authors: Francisco de Assis
authors: Fde A
authors: Gonçalves-Filho
authors: Geni Satomi
authors: GS
authors: Cunrath
authors: João Gomes
authors: JG
authors: Netinho
mesh_terms: 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