ประโยชน์ของการส่องกล้องตรวจลำไส้ใหญ่ และตัดชิ้นเนื้อส่งตรวจทางพยาธิวิทยาในการวินิจฉัยโรคในกลุ่มผู้ป่วยที่ไม่ได้ติดเชื้อเอดส์ที่มาด้วยอาการถ่ายเหลวเรื้อรัง

บทคัดย่อ

Objective: To evaluate diagnostic yield of colonoscopy and biopsy with ileoscopy in non-HIV patients presented with chronic diarrhea.

Material and methods: Prospective study of non-HIV patients presented with chronic diarrhea at Nakhonpathom hospital since October 2010 - January 2013 was done by assessing clinical features, laboratory features, endoscopic findings from colonoscopy with distul ileoscopy, and histopathological results to identify etiology of chronic diarrhea.

Results: Overall patients in this study were 65 (male 33, female 32) with mean age of 55.1 ± 14.8 years. Mean duration of diarrhea was 29.4 ± 60.3 weeks. The most common endoscopic findings from colonoscopy were normal mucosa (n = 31, 47.7%) followed by focal colitis (n = 12, 18.5%) and cauliflower masses (n =11, 16.9%). Colonoscopy and biopsy yielded a specific diagnosis in 26 (40%) patients. These include colorectal cancer (n = 11), tuberculous ileocolitis (n = 4), ulcerative colitis (n = 4), lymphocytic colitis (n = 4), tubulovillous adenoma size 2 cm (n = 2) and NSAIDs associated colitis (n =1). Ileoscopy was performed in 42 patients and was abnormal in 4 patients (9.5%). No patients had the sole abnormality on ileoscopy.

Conclusions: Colonoscopy and biopsy is useful in the investigation of non-HIV patients with chronic diarrhea yielding a specific diagnosis in 40% of patients without a previous diagnosis. Ileoscopy complemented colonoscopy findings in a minority of patients with chronic diarrhea and add some information for a diagnosis in only two patients. Ileal biopsy unhelpful when ileoscopy was normal.