All ileo-cecal ulcers are not Crohn’s:Changing perspectives of symptomatic ileocecal ulcers

• 作者: Amit Thawrani Anil Arora Ashish Kumar Hardik L Kotecha Jay Toshniwal Mandhir Kumar Mohan Goyal Munish Sachdeva Naresh Bansal Pankaj Jain Pankaj Tyagi Piyush Ranjan Praveen Sharma Rajesh Sharma Rinkesh Bansal Romesh Chawlani Sunita Bhalla Vijendra Kirnake Vikas Singla Vineet Shah
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Ileocecal Crohns 疾病 传播大 B 房间 non-hodgkins 淋巴瘤
• 年，卷（期）: 2017,（7）
• 页码范围: 327-333
• 页数: 7页
• 分类号: R574

摘要

AIM To investigated clinical,endoscopic and histopathological parameters of the patients presenting with ileocecal ulcers on colonoscopy.METHODS Consecutive symptomatic patients undergoing colonoscopy,and diagnosed to have ulcerations in the ileocecal(I/C) region,were enrolled.Biopsy was obtained and theirclinical presentation and outcome were recorded.RESULTS Out of 1632 colonoscopies,104 patients had ulcerations in the I/C region and were included in the study.Their median age was 44.5 years and 59% were males.The predominant presentation was lower GI bleed(55,53%),pain abdomen ± diarrhea(36,35%),fever(32,31%),and diarrhea alone(9,9%).On colonoscopy,terminal ileum was entered in 96(92%) cases.The distribution of ulcers was as follows:Ileum alone 40%(38/96),cecum alone 33%(32/96),and both ileum plus cecum 27%(26/96).The ulcers were multiple in 98% and in 34% there were additional ulcers elsewhere in colon.Based on clinical presentation and investigations,the etiology of ulcers was classified into infective causes(43%) and noninfective causes(57%).Fourteen patients(13%) were diagnosed to have Crohn’s disease(CD).CONCLUSION Non-specific ileocecal ulcers are most common ulcers seen in ileo-cecal region.And if all infections are clubbed together then infection is the most common(> 40%) cause of ulcerations of the I/C region.Cecal involvement and fever are important clues to infective cause.On the contrary CD account for only 13% cases as a cause of ileo-cecalulcers.So all symptomatic patients with I/C ulcers on colonoscopy are not Crohn’s.