Original Article: Clinical EndoscopyTerminal ileal photography or biopsy to verify total colonoscopy: does the endoscope agree with the microscope?
Section snippets
Patients and methods
A total of 232 unselected patients referred to our unit for colonoscopy, in whom TI intubation was achieved, were prospectively audited. All patients were aged 18 years or over. All patients underwent ileocolonoscopy while under conscious sedation with intravenous midazolam 2 to 4 mg (Hameln Pharmaceuticals, Gloucester, UK) and either fentanyl 75 to 100 mg (Martindale Pharmaceuticals, Romford, UK) or pethidine 25 to 50 mg (Auden McKenzie [Pharma division] Ltd, London, UK). Hyoscine butylbromide
Results
A total of 232 colonoscopies were performed with paired TI photograph and biopsy. The mean (standard deviation) age of patients was 52.0 ± 18.5 years (95% confidence interval 49.6-55.4), with an age range of 18-93 years. There were 131 women and 101 men. The most common indication was diarrhea, present in 43.5% of patients. Other indications included rectal bleeding (18.4%), assessment or surveillance of IBD (17.5%), and anemia (13.5%). Abdominal pain was a feature in 21.1%. Other indications,
Discussion
ASGE guidelines concerning quality indicators for colonoscopy suggest that visualization and photodocumentation of the cecum should be performed in all colonoscopies.1 However, the ASGE concedes that cecal photography “may not be convincing in all cases.” The unreliability of cecal landmarks to document the extent of colonic examination is corroborated by prospective studies.3, 4 We prospectively demonstrated that TI photography was an effective means of documenting total colonoscopy. It is a
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2011, Digestive and Liver DiseaseCitation Excerpt :In addition to inflammatory bowel disease, diarrhoea is considered by some an indication for colonoscopy with ileoscopy [7]. In most studies, the rate of abnormal findings (not always specifically defined) in the ileum of patients with diarrhoea is around 5% [15]. In a study of 138 patients with chronic, non-bloody diarrhoea, histologic lesions were seen in 42.0%, and a final diagnosis of Crohn's disease was made based on endoscopic and histologic findings in 5.8% of patients [16].
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