Terminal ileum intubation during colonoscopy: Should it be routinely performed on all patients?

Aim: The aim of this study was to evaluate the diagnostic yield and the usefulness of ileoscopy in a tropical setting. Patients and Methods: Colonoscopy was performed on consenting patients using Olympus Exera III Videocolonoscope (CF HQ190 L, Olympus UK). Terminal ileum intubation was attempted in all the patients who had cecal intubation. A pro forma was used to record information such as biodata of the patients, indications for the procedure, and the findings, including that of the intubated terminal ileum. Results: The colonoscopy results of 305 patients comprising 168 (55.1%) males and 137 (44.9%) females were analyzed. Cecum was reached in 272 (89.2%) patients and successful terminal ileum intubation was achieved in 84/272 (30.9%) patients. Macroscopically, 82 (97.6%) patients had normal ileum, while abnormal findings were recorded in two patients, giving a diagnostic yield of 2.4% (2/84). The various abnormalities were ulcers, polypoid lesions, and cobblestone appearance. Of the 16 (19%) patients who had a biopsy of the terminal ileum, microscopic abnormalities were seen in 15 (93.7%) patients while 1 (6.3%) patient had normal ileal histology. Conclusion: The diagnostic yield of ileoscopy in this study was very low, and hence, it may not be routinely necessary in all patients in our practice.