1. 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 One year later, spontaneous termina ileum insertion was recorded during daily practice from July 2015 to November 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 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% ( %) The success rate was increased to 87% from Oct 2014 to Jun 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.