AIM： To evaluated the role of hyoscine butyl bromide in facilitating retrograde ileoscopy. METHODS： Retrograde terminal ileoscopy was attempted in 200 consecutive patients undergoing colonoscopy. After intubation of...AIM： To evaluated the role of hyoscine butyl bromide in facilitating retrograde ileoscopy. METHODS： Retrograde terminal ileoscopy was attempted in 200 consecutive patients undergoing colonoscopy. After intubation of the cecum and visualization of the ileocecal valve, butyl bromide injection or normal saline was given intravenously to the patients in a double blind random fashion. The pulse rate and oxygen saturation were measured continuously. After completion of the procedure, endoscopists were then asked to score the ease of intubation and the ease of visualization of the terminal ileum on a visual scale of 1 to 10. The patients were also asked to score the pain after receiving hyoscine butyl bromide injection on a score of 1 to 10. RESULTS： Terminal ileoscopy could be performed in 188 patients. The mean （SD） visual analogue score for the ease of intubation of the cecum was 7.4 （0.65） in the injection group and 5.9 （0.8） in the placebo group （P 〈 0.001）. The mean （SD） length of ileum visualized in the injection group was 14.4 （3.3） cm and 10.4 （2.7） cm in the placebo group （P 〈 0.001）. The mean （SD） visual analogue score for ease of visualization of the terminal ileum was 7.5 （0.69） in the injection group and 5.9 （0.7） in the placebo group （P 〈 0.001）. The pain score experienced by the patients was 6.5 （0.7） in the injection group and 6.7 （0.69） in the placebo group （P 〈 0.008）. Although the pulse rate increased significantly in patients receiving the drug, no statistically significant difference was noted in the oxygen saturation between the two groups either before or after administration of the drug. No complications were observed in either of the groups. CONCLUSION： Hyoscine butyl bromide injection is a useful adjunct in helping the intubation and visualization of terminal ileum during colonoscopy.展开更多
AIM： To assess the role of retrograde terminal ileoscopy in hematochezia patients with normal colonoscopy. METHODS： Between January 1997 and March 2005, 39 hematochezia patients （males 36, females 3, mean age 44.7 ...AIM： To assess the role of retrograde terminal ileoscopy in hematochezia patients with normal colonoscopy. METHODS： Between January 1997 and March 2005, 39 hematochezia patients （males 36, females 3, mean age 44.7 years） with a reported normal colonoscopy underwent a repeat colonoscopy. After reaching the cecum, attempt was made to localize the ileocecal valve and intubate the terminal ileum. Any abnormality in the mucosa of the terminal ileum was carefully recorded and biopsies were obtained from suspiciouslooking lesions. RESULTS： During the study period there were 39 patients admitted for hematochezia in whom colonoscopy till cecum did not reveal any abnormality. Fulllength colonoscopy till the cecum could be performed in all the patients. The terminal ileum could be intubated in 36 patients. No abnormality was noted in 31 patients. Ileal ulcers were noted in two patients. Noclularity along with ulceration of the ileal mucosa, a Dieulafoy＇s lesion, and an angiomatous malformation were noted in one patient each. Histological examination of the biopsies obtained from the ulcers revealed typical tuberculous lesion in the patient with nodularity and ulceration. One of the patients had typhoid ulcers and another had non-specific ulcers. CONCLUSION： Retrograde terminal ileoscopy gives limited but valuable information, in patients with hematochezia and should be attempted in all such patients.展开更多
文摘AIM： To evaluated the role of hyoscine butyl bromide in facilitating retrograde ileoscopy. METHODS： Retrograde terminal ileoscopy was attempted in 200 consecutive patients undergoing colonoscopy. After intubation of the cecum and visualization of the ileocecal valve, butyl bromide injection or normal saline was given intravenously to the patients in a double blind random fashion. The pulse rate and oxygen saturation were measured continuously. After completion of the procedure, endoscopists were then asked to score the ease of intubation and the ease of visualization of the terminal ileum on a visual scale of 1 to 10. The patients were also asked to score the pain after receiving hyoscine butyl bromide injection on a score of 1 to 10. RESULTS： Terminal ileoscopy could be performed in 188 patients. The mean （SD） visual analogue score for the ease of intubation of the cecum was 7.4 （0.65） in the injection group and 5.9 （0.8） in the placebo group （P 〈 0.001）. The mean （SD） length of ileum visualized in the injection group was 14.4 （3.3） cm and 10.4 （2.7） cm in the placebo group （P 〈 0.001）. The mean （SD） visual analogue score for ease of visualization of the terminal ileum was 7.5 （0.69） in the injection group and 5.9 （0.7） in the placebo group （P 〈 0.001）. The pain score experienced by the patients was 6.5 （0.7） in the injection group and 6.7 （0.69） in the placebo group （P 〈 0.008）. Although the pulse rate increased significantly in patients receiving the drug, no statistically significant difference was noted in the oxygen saturation between the two groups either before or after administration of the drug. No complications were observed in either of the groups. CONCLUSION： Hyoscine butyl bromide injection is a useful adjunct in helping the intubation and visualization of terminal ileum during colonoscopy.
文摘AIM： To assess the role of retrograde terminal ileoscopy in hematochezia patients with normal colonoscopy. METHODS： Between January 1997 and March 2005, 39 hematochezia patients （males 36, females 3, mean age 44.7 years） with a reported normal colonoscopy underwent a repeat colonoscopy. After reaching the cecum, attempt was made to localize the ileocecal valve and intubate the terminal ileum. Any abnormality in the mucosa of the terminal ileum was carefully recorded and biopsies were obtained from suspiciouslooking lesions. RESULTS： During the study period there were 39 patients admitted for hematochezia in whom colonoscopy till cecum did not reveal any abnormality. Fulllength colonoscopy till the cecum could be performed in all the patients. The terminal ileum could be intubated in 36 patients. No abnormality was noted in 31 patients. Ileal ulcers were noted in two patients. Noclularity along with ulceration of the ileal mucosa, a Dieulafoy＇s lesion, and an angiomatous malformation were noted in one patient each. Histological examination of the biopsies obtained from the ulcers revealed typical tuberculous lesion in the patient with nodularity and ulceration. One of the patients had typhoid ulcers and another had non-specific ulcers. CONCLUSION： Retrograde terminal ileoscopy gives limited but valuable information, in patients with hematochezia and should be attempted in all such patients.
