Name of the Procedure:

Ileoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

Summary

An ileoscopy through stoma is a diagnostic procedure where a thin, flexible tube with a camera (endoscope) is inserted through a stoma (an artificial opening in the abdomen leading to the ileum). This helps the doctor to visually examine the ileum (the last part of the small intestine) and collect tissue specimens by brushing or washing the area.

Purpose

This procedure is performed to diagnose, assess, and monitor conditions affecting the ileum. It helps identify sources of symptoms like abdominal pain, bleeding, or alterations in bowel habits. It can also monitor known conditions such as Crohn's disease or check for post-surgical complications.

Indications

• Unexplained abdominal pain
• Gastrointestinal bleeding
• Chronic diarrhea
• Suspected Crohn's disease or other inflammatory bowel diseases (IBD)
• Post-surgical assessment of stoma complications

Preparation

• Patients may be required to fast for 6-8 hours before the procedure.
• Certain medications might need to be paused or adjusted as advised by the doctor.
• Laxatives or enemas may be used to clear the bowel.
• Pre-procedural diagnostic tests like blood work or imaging scans might be performed.

Procedure Description

1. The patient is positioned comfortably, usually lying on their side.
2. Sedation or local anesthesia may be administered to ensure comfort.
3. The endoscope is gently inserted through the stoma into the ileum.
4. The doctor examines the ileum visually with the help of the camera.
5. Tissue samples may be collected by brushing or washing the area.
6. The endoscope is then carefully removed.

Tools used:

• Flexible endoscope with camera
• Brushes or tools for tissue collection
• Sedation or local anesthesia medications

Duration

Typically, the procedure takes about 30-60 minutes.

Setting

The procedure is generally performed in a hospital, outpatient clinic, or specialized surgical center.

Personnel

• Gastroenterologist or colorectal surgeon
• Nurses or medical assistants
• Anesthesiologist (if sedation is used)

Risks and Complications

Common Risks:

• Mild discomfort or pain
• Bloating or gas
• Minor bleeding at the site of tissue collection

Rare Complications:

• Perforation of the intestine
• Significant bleeding
• Adverse reaction to sedation or anesthesia

Benefits

• Accurate diagnosis of intestinal conditions
• Monitoring and management of known conditions
• Insight into treatment efficacy
• Identification and management of post-surgery complications Benefits are generally realized within a few days to weeks, as it guides further treatment plans.

Recovery

• Patients may rest and recover from sedation or anesthesia before heading home.
• Mild cramping or bloating may occur but typically resolves within a day.
• Normal activities can usually be resumed within 24-48 hours.
• Follow-up appointments may be scheduled to discuss findings and treatment plans.

Alternatives

• Abdominal X-rays or CT scans
• Capsule endoscopy
• Blood tests and non-invasive imaging While these alternatives may be less invasive, they might not provide as detailed a view or allow for direct tissue sampling.

Patient Experience

During the procedure:

• Limited discomfort due to sedation
• Sensation of pressure or mild cramping

After the procedure:

• Mild soreness at the stoma site
• Possible bloating or gas relief

Pain management is generally minimal but can include over-the-counter pain relief if needed. Comfort measures include resting and a gradual return to normal activities.