title: Usefulness of Routine Terminal Ileoscopy and Biopsy during Colonoscopy in a Tropical Setting: A Retrospective Record-Based Study.
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%)) (P = 0.0048, χ (2) = 7.968). Conclusion. TI and biopsy improve diagnostic yield of colonoscopy in patients with RIF pain, diarrhoea, anaemia, suspected IBD, and raised inflammatory markers.
authors.affiliation: University Medical Unit, Colombo North Teaching Hospital, 11010 Ragama, Sri Lanka.
authors.forename: Hasitha Srimal
authors.initials: HS
authors.lastname: Wijewantha
authors.affiliation: University Medical Unit, Colombo North Teaching Hospital, 11010 Ragama, Sri Lanka.
authors.forename: Arjuna Priyadarsin
authors.initials: AP
authors.lastname: de Silva
authors.affiliation: University Medical Unit, Colombo North Teaching Hospital, 11010 Ragama, Sri Lanka ; Department of Medicine, Faculty of Medicine, P.O. Box 06, Thalagolla Road, 11010 Ragama, Sri Lanka.
authors.forename: Madunil Anuk
authors.initials: MA
authors.lastname: Niriella
authors.affiliation: University Medical Unit, Colombo North Teaching Hospital, 11010 Ragama, Sri Lanka.
authors.forename: Nethini
authors.initials: N
authors.lastname: Wijesinghe
authors.affiliation: University Medical Unit, Colombo North Teaching Hospital, 11010 Ragama, Sri Lanka.
authors.forename: Prabahvi
authors.initials: P
authors.lastname: Waraketiya
authors.affiliation: University Medical Unit, Colombo North Teaching Hospital, 11010 Ragama, Sri Lanka.
authors.forename: Ravindu Sujeewa
authors.initials: RS
authors.lastname: Kumarasena
authors.affiliation: Department of Pharmacology, Faculty of Medicine, University of Kelaniya, 11010 Ragama, Sri Lanka.
authors.forename: Anuradha Supun
authors.initials: AS
authors.lastname: Dassanayake
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Kelaniya, 11010 Ragama, Sri Lanka.
authors.forename: Janaki de Silva
authors.initials: Jde S
authors.lastname: Hewawisenthi
authors.affiliation: University Medical Unit, Colombo North Teaching Hospital, 11010 Ragama, Sri Lanka.
authors.forename: Hithanadura Janaka
authors.initials: HJ
authors.lastname: de Silva