Routine ileal intubation during screening colonoscopy: A useful maneuver?

Background: The utility of routine ileoscopy as a component of screening colonoscopy is unclear. Many endoscopists believe that routine intubation of the terminal ileum is a requirement for a full-screening colonoscopy. The authors have hypothesized that routine ileal intubation during screening colonoscopy is of little diagnostic value. Methods: A retrospective analysis was performed using a prospectively maintained colonoscopy database of patients identified as undergoing a screening colonoscopy. All had undergone intubation of the terminal ileum at a tertiary referral center. Those who had undergone screening colonoscopy at the Mayo Clinic (Rochester, MN) were entered prospectively into a database. The study identified 6,408 patients who met the criteria of having terminal ileal intubation at the time of screening colonoscopy. The main outcome measured was abnormality of the terminal ileum at ileal intubation. Results: Ileoscopy showed grossly abnormal findings for only 1% of the patients, and pathologic abnormalities were identified for only 0.3% of all the patients. Conclusions: The findings support the conclusion that intubation of the terminal ileum should not be a required part of screening colonoscopy.