Comparison of Colonoscopy and Histopathological Findings in Terminal Ileum Lesions

Abstract

Abstract Objective In diseases affecting the terminal ileum, the gold standard approach is to image the terminal ileum using colonoscopy and take a biopsy sample. This study aimed to compare the colonoscopic appearance and histopathological findings of the terminal ileum from a diagnostic perspective. Materials and Methods Data were retrospectively collected by screening the files of 971 patients who underwent colonoscopy at the gastroenterology clinic of Celal Bayar University Faculty of Medicine between January 2014 and July 2023. The patients’ demographic data, such as age and gender, were recorded. Colonoscopy reports and histopathological findings were evaluated. Results Of the patients, 457 (47%) were women, and 514 (53%) were men. The mean age was 47.7 years. The number of patients with a normal terminal ileum, both colonoscopically and histopathologically, was 562 (57.8%). The most common finding in the terminal ileum, both colonoscopically and histopathologically, was edematous mucosa 6.1%. The rate of histopathological ileitis detection in patients with a normal terminal ileum on colonoscopy was 4% (27), and the rate of the pathological detection of chronic inflammatory bowel disease in those with an ileal ulcer was 49.1% (28). Conclusion The results of this study showed that the colonoscopic appearance and histopathological findings of terminal ileum lesions were significantly correlated; therefore, both are equally valuable in the diagnosis of ileal diseases. Additionally, ileum intubation and histopathological evaluation must be performed when clinically necessary.

Keywords

• colonoscopy
• histopathology
• ileum
• diagnostic value

Ethical Statement

The study was conducted in accor¬dance with the principles of the Declaration of Helsinki, and the study protocol was approved by the Health Sciences Ethics Committee of Celal Bayar University Medical School (date: 31/08/2023; number: 2021/20.478.486/1963).

Comparison of Colonoscopy and Histopathological Findings in Terminal Ileum Lesions

Abstract

Öz Giriş ve Amaç Terminal ileumu etkileyen hastalıklarda kolonoskopi ile terminal ileumun görüntülenmesi ve biyopsi alınması altın standarttır. Bu çalışmada kolonoskopik görünüm ile terminal ileumun histopatolojik bulgularının tanısal açıdan karşılaştırılması amaçlandı. Gereç ve Yöntemler 2014-2023 yılları arasında Celal Bayar Üniversitesi Tıp Fakültesi Gastroenteroloji kliniğinde kolonoskopi yapılan 971 hasta dosyası retrospektif incelenerek veriler toplandı. Hastaların yaş ve cinsiyet gibi demografik verileri kaydedildi. Kolonoskopi raporları ve histopatolojik bulguları değerlendirildi. Sonuçlar Hastaların 457’si (%47 ) kadın, 514’ü (%53) erkekti. Yaş ortalaması 47,7’di. Hem kolonoskopik hem de histopatolojik olarak terminal ileumu normal olan hasta sayısı 562(%57,8)’di. Terminal ileumda hem kolonoskopik hem de histopatolojik olarak en fazla görülen bulgu mukozal ödemdi (%6,1). Kolonoskopide normal terminal ileumu olanlarda histopatolojik olarak ileit saptanma oranı 27(%4) ve ileal ülser olanlarda patolojik olarak kronik inflamatuar barsak hastalığı saptanma oranı ise 28(%49,1)’di. Tartışma Kolonoskopik görünüm ile histopatolojik bulguların anlamlı oranda korele olduğu gösterildi. Bundan dolayı ileal hastalıkların tanısında hem kolonoskopik görünüm hem de histopatolojik bulgular aynı oranda değerlidir. Ayrıca klinik olarak gerekli durumlarda ileum entübasyonu ve histopatolojik değerlendirme mutlaka yapılmalıdır.

Keywords

• kolonoskopi
• histopatoloji
• ileum
• tanı değeri

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