Changing Scenario of Symptomatic isolated Terminal Ileal Ulcers: Histopathological, Molecular diagnosis and Clinical profile in a tertiary level hospital, Dhaka

Abstract

BACKGROUND: Isolated symptomatic terminal ileal ulcers are being many times encountered by the gastroenterologist with the increasing numbers of ileal intubation during colonoscopies. The aim of the study was to investigate the etiologies of isolated terminal ileal ulcers (ITIUs) in symptomatic patients during ileoscopic procedure  at a tertiary level hospital, in Bangladesh.

METHODS: This was a cross sectional, descriptive study performed on all consecutive patients aged 18 years and above of both gender who underwent ileocolonoscopy for various gastrointestinal symptoms between 1 January 2023 and 30 June 2023. Clinical, ileocolonoscopic and histopathological findings were analyzed to determine the etiology of isolated symptomatic terminal ileal ulcers. The study was done in the department of Gastroenterology, Shaheed Suhrawardy Medical College hospital, Dhaka.

RESULTS: The study population consisted of 50 respondents, among them, 76.0% male and 24.0% female. The majority (32.0%) of the study population belonged to age group of 31-40 years and the mean age of them 35.76 ± 15.24 years. The most common symptoms reported by patients had weight loss (72.0%), abdominal pain (70.0%). 44% fever, 42.0% diarrhea and 40.0%  alternate Constipation with Diarrhea. Ileoscopic findings revealed that among the 50 respondents, 42(84.0%) had multiple ulcer and 8(16.0%) had solitary ulcer. Histological findings revealed that among the 50 respondents, 37(74.0%) were non specific ileitis while 7(14.0%) had tuberculosis and 6(12.0%) had Crohn’s disease.

 CONCLUSION: Specific etiologies such as tuberculosis (14%), Crohn’s disease (12%) were seen in this study. The most common ileoscopic findings were non-specific ileitis (74%). No clinical presentation was significantly correlated with any specific etiology. So routine ileal intubation and tissue sampling for histopathological examination is required in all symptomatic patients undergoing colonoscopy. A follow-up colonoscopy

Bangladesh J Medicine 2026; Vol. 37, No. 2(1): pp. 224