Gastrointestinal endoscopy · 2010
Isolated terminal ileal ulcerations in asymptomatic individuals: natural course and clinical significance.
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Chang Hye-Sook, Lee Don, Kim Jong Cheol, Song Hye-Kyung, Lee Hyun Ju, Chung Eun-Ju, Kim Tae Hyup, Park Hye-Won, Byeon Jeong-Sik, Yang Suk-Kyun, Choe Jae-Won
Аннотация
BACKGROUND: Although isolated terminal ileal ulcerations (ITIUs) are occasionally observed on colonoscopic examination of asymptomatic individuals, their clinical course and guidelines for treatment are unclear.
OBJECTIVE: To evaluate the clinical course and significance of ITIUs in asymptomatic individuals.
DESIGN: Single-center retrospective analysis.
SETTING: University hospital.
PATIENTS AND INTERVENTIONS: All patients diagnosed with ITIUs on colonoscopy from July 2001 to December 2007 were identified. Patients with colorectal symptoms, a history of nonsteroidal anti-inflammatory drug consumption, a history of colorectal surgery, oral or genital ulcerations, and coincidental ulceration in the ileocecal valve or colon were excluded.
MAIN OUTCOME MEASUREMENTS: Colonoscopic findings and clinical courses of patients were analyzed.
RESULTS: Of the 148 included patients, 93 were followed (mean duration, 29.9 months). Of these, 62 showed resolution of ITIU on follow-up colonoscopy, including 60 who resolved without any treatment and 2 who resolved after antituberculosis medication. Follow-up colonoscopy continued to show ITIUs in the remaining 31 patients, only 1 of whom developed typical Crohn's disease, whereas the other 30 showed no significant changes in the lesions (n = 22), partial improvement (n = 6), or waxing and waning endoscopic appearance (n = 2).
LIMITATIONS: Retrospective design, relatively short-term follow-up.
CONCLUSIONS: Most ITIUs incidentally observed in asymptomatic individuals resolve without any treatment. Even if these lesions persist, it is unusual for them to progress or to cause any symptoms.
OBJECTIVE: To evaluate the clinical course and significance of ITIUs in asymptomatic individuals.
DESIGN: Single-center retrospective analysis.
SETTING: University hospital.
PATIENTS AND INTERVENTIONS: All patients diagnosed with ITIUs on colonoscopy from July 2001 to December 2007 were identified. Patients with colorectal symptoms, a history of nonsteroidal anti-inflammatory drug consumption, a history of colorectal surgery, oral or genital ulcerations, and coincidental ulceration in the ileocecal valve or colon were excluded.
MAIN OUTCOME MEASUREMENTS: Colonoscopic findings and clinical courses of patients were analyzed.
RESULTS: Of the 148 included patients, 93 were followed (mean duration, 29.9 months). Of these, 62 showed resolution of ITIU on follow-up colonoscopy, including 60 who resolved without any treatment and 2 who resolved after antituberculosis medication. Follow-up colonoscopy continued to show ITIUs in the remaining 31 patients, only 1 of whom developed typical Crohn's disease, whereas the other 30 showed no significant changes in the lesions (n = 22), partial improvement (n = 6), or waxing and waning endoscopic appearance (n = 2).
LIMITATIONS: Retrospective design, relatively short-term follow-up.
CONCLUSIONS: Most ITIUs incidentally observed in asymptomatic individuals resolve without any treatment. Even if these lesions persist, it is unusual for them to progress or to cause any symptoms.