Colonscopy and ileoscopy are available in painless endoscopy as EGD into duodenum 做胃鏡經幽門進十二指腸，做大腸鏡經迴盲瓣進迴腸：看見小腸 ！ Chi-Yi Chen, Ming-Tse Hsu, Tsung-Jung Tsai, Yu-Min Feng, Cho-Lun Tsai , Chang-Chao Su, Li-Jen Chang, Chien-Chung Fang, Yu-Ling Lin, Tai-Tien Chung, Chu-Kuang Chou, Po-Yueh Chen 陳啟益，許銘澤，蔡崇榮，酆裕民，蔡卓倫，蘇昶昭， 張力仁，方建忠，林玉玲，鍾泰天，周莒光，陳柏岳 GI section of Internal Medicine department, Chia-Yi Christian Hospital, Chia-Yi, Taiwan 嘉義基督教醫院胃腸肝膽科 Introduction Table1. ileum Ulcer Success Rate Routine esophagogastroduodenoscopy (EGD) was inserted into duodenum through pyloric ring in spite of lower duodenal ulcers and duodenal lesions. Regular colonscopy can be inserted into terminal ileum through ileocecal valve in painless colonscopy in spite of lower positive endoscopic lesions.Could colonscopy and ileoscopy be available in our daily painless endoscopy? Aims To evaluate the successful rate of terminal ileal insertion during painless colonscopy. Table2. Ulcer Rate of ileoscopy Materials and Methods Routine terminal ileum insertion through ileocecal valve was performed with intention during painless colonscopy from July 2014 to June 2015. One year later, spontaneous termina ileum insertion was recorded during daily practice from July 2015 to November 2015. There were 11 GI specialists included. Endoscopic target lesions were defined as ulceration, tumor and polyps. Results There were 8512 sessions of painless colonscopy from July 2014 to November 2015. Successful terminal ileum insertion was achieved in 3232 session. The success rate was 37.9% During the first 3 months( June-September 2014) the average success rate was 78% ( 72-80-82%) The success rate was increased to 87% from Oct 2014 to Jun 2015. Unfortunately, the successful insertion rate decreased to 24% ( 626/2612) without the request of study nurse. Spontaneous ICV insertion were only performed in experienced endoscopists with previous high success rate about 90%. There were 124 ulcers noted with positive rate of 3.8%. There were 290 polyps lesion noted with positive rate of 12.4%. Unfortunately, no cancer lesion was revealed. The negative finding was 87.6% in our ileoscopy. Table3. ileoscopy Total：3232 No polyp and Ulcer：2831 (87.6%) Polyp+ Ulcer：13 (12.4%) Dr. A B C D E F G H I J K Total Namber 1010 497 320 271 256 248 198 194 171 35 32 3232 Polyp 129 101 16 13 6 2 3 1 277 Ulcer 64 12 10 4 111 Polyp+ Ulcer 7 Ulcer (+) 7.0 2.6 1.9 3.2 1.6 2.8 2.0 2.1 1.8 25 Positive Rate (%) 19.8 22.9 6.9 6.7 3.9 3.6 3.5 3.1 2.9 6.3 82.5 Table4. In terminal ileum Conclusions A B C D E F G H I J K Total Number 1010 497 320 271 256 248 198 194 171 35 32 3232 Ulcer case 71 13 6 12 4 7 3 124 Ulcer (+) % 7.0 2.6 1.9 3.2 1.6 2.8 2.0 2.1 1.8 2.27 (average) It was available to perform ileoscopy through ICV in painless colonscopy. It can make sure of completion of colonscopy with 3.8% ulceration rate and 12.4% polyps extra-findings. The success of ileoscopy can be achieved from 78% to 84% during first months. It was easy to achieve 90% insertion after 3 months. It may be possible to find out more ulcer lesions with sequential healing process during longterm follow-up.