Journal of Clinical Case Reports

Abstract

Osamah Tahir Muslim* and Hasan Osamah Al-Obaidi

Background: Colonoscopy is considered to be the procedure of choice for both the diagnosis and treatment of large bowel diseases. Inspection of the whole colonic and distal portion of terminal ilial mucosa is usually feasible during colonoscopy.Colonoscopy is the best diagnostic tool to evaluate the large intestine and distal Ilium in patients complaining from bowel symptoms, anemia resulting from malabsorption, those with radiographic abnormalities of the colon, screening for colorectal carcinoma, after both polypectomy and cancer resection surveillance, surveillance in Ulcerative Colitis, and in those with suspicion of neoplastic masses. Quality examination of large bowel includes intubation of the whole colon and a thorough mucosal visualization. The investigators demonstrate that terminal ilium intubation is possible in endoscopy practice and at many times yields additional clinical details. Furthermore, it may be used as an indicator of colonoscopy completion.

Objectives: Is to estimate the rate of Cecal and Ilial Intubation in by a single well trained endoscopist as quality Indicator of colonoscopy and compare it with the same rates of heterogeneous group of endoscopists.

Patients and Method: This is a retrospective comparative study that estimate the rate of Cecal and Ilial Intubation in a Private Endoscopy Center in which all endoscopic procedures conducted by a single endoscopist who has fellowship in gastroenterology and compare it with the rates of a governmental center in which colonoscopy is done by five endoscopists including general surgeons, general physicians and trained in endoscopy as well as gastroenterologists who has gastroenterology fellowship. The study population included (442 patients); 245 males (55.42%) and 197 females (44.58%); ranging from 14 up to 85 years age.

Results: Overall Cecal and Ilial intubation rates were 88% and 47.5% Respectively; After considering cases of anatomic colonic obstruction and when the clinical indications don’t justify total colonic intubation; the adjusted rates were 49.2% & 50.8% for cecal & Ilial intubations respectively; and these figures were superior in comparison to the results of multioperator study in which the cecal intubation rate was 51.81% and the ilila intubation rate was 30.69%.

Conclusions: Cecal and Ilial intubation are important quality indicators for colonoscopy and in this study they are found to be superior in qualified gastroenterologist than in general surgeons & physicians; this result points to the importance of providing endoscopy units in Iraq with qualified well trained endoscopy personnel.

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