Diagnostic value of terminal ileum biopsies in patients with abnormal terminal ileum mucosal appearance
Mehmet Velidedeoğlu, A. Enes Arıkan, A. Kağan Zengin
Department of General Surgery, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
Objective: To investigate the necessity of obtaining routine ileal biopsy during colonoscopy in the patients with abnormal terminal ileum mucosal appearance if the inflammatory bowel disease is not considered.
Material and Methods: A retrospective analysis was performed for 57 patients who were referred to a private hospital for colonoscopy between January 2008 and February 2009, in whom terminal ileum intubation was achieved and an abnormal appearance was observed.
Results: There were 33 men and 24 women; the mean age was 44.12±11.42 years. In 22 patients, the abnormality was ulcers and/or erosions. In 10 patients, there were mucosal nodularity and in 24, the finding was erythema. The time to reach to ileum from cecum was 28.78±24.30 s. The mean length of the examined ileum was 12.93±6.05 cm. There was no difference between groups according to distance covered in the ileum for diagnostic yield, but going further than 2 cm was important.
Conclusion: There should be no need to obtain routine biopsy in patients with abnormal terminal ileum mucosa appearance, when inflammatory bowel disease is not considered. In these patients, histopathology also reveals non-specific ileitis. Furthermore, in these patients, the macroscopic pathological diagnosis overlaps the histopathology, and it has a low diagnostic yield and lower clinical significance.
Keywords: Colonoscopy, terminal ileum, biopsy
Because this is a retrospective study, no ethical approval was seeked.
Written informed consent was obtained from patient who participated in this study.
Concept - M.V., A.K.Z., A.E.A.; Design - M.V., A.K.Z.; Supervision - A.K.Z., M.V.; Funding - M.V.; Materials - M.V.; Data Collection and/or Processing - M.V.; Analysis and/or Interpretation - M.V.; Literature Review - A.E.A.; Writer - M.V., A.K.Z.; Critical Review - M.V., A.K.Z.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.