A PROSPECTIVE EVALUATION OF SUCCESSFUL TERMINAL ILEUM INTUBATION DURING ROUTINE COLONOSCOPY

This study prospectively evaluated a dedicated effort to intubate the terminal ileum in an unselected population of patients undergoing colo noscopy in conjunction with our training program. The influence of the visual appearance of the terminal ileal mucosa on patient management was assessed subjectively. The cecum was reached in 270/295 (91%) pati ents, with successful terminal ileal intubation being accomplished in 213/270 (79%) examinations. The time required to intubate the terminal ileum (x = 3.4 minutes; range, 30 seconds to 10 minutes) was not sign ificantly different (p < 0.05) between the several levels of training in our fellowship program. The terminal ileum was considered to be vis ually abnormal in 4 cases, but only 1 of these was abnormal on histolo gic examination. In this unselected population, routine ileoscopy was unrewarding for finding an incidental positive diagnosis; however, bri ef attempts at terminal ileal intubation may be useful to improve or m aintain endoscopic skills, especially in a training setting.