末端回肠溃疡可以有各种病因,包括克罗恩病(CD),感染,和药物相关的原因。本研究旨在调查结肠镜检查中发现的末端回肠溃疡的发生率,探索它们的根本原因,分析他们的临床,内窥镜,和组织病理学特征。此外,该研究旨在确定表明需要随访的预测因素.所有接受结肠镜检查的患者的医疗记录,2009年至2019年期间进行了回顾性审查。回肠终末溃疡患者,有或没有回盲瓣受累,包括在研究中。人口统计信息,药物使用,症状,结肠镜检查结果,并对这些患者的组织病理学资料进行分析。共有398名患者被纳入研究。组织病理学检查显示243例患者(61%)有活动性回肠炎,69例患者(17.4%)患有慢性活动性回肠炎。溃疡的最终诊断为:212例患者(53.3%)的非特异性溃疡,66例CD患者(16.6%),58例(14.6%)患者出现非甾体抗炎药所致溃疡。在多变量分析中,预测CD的参数包括10个或更多溃疡的存在(比值比(OR)=7.305),深部溃疡(OR=7.431),和水肿周围组织(OR=5.174),所有这些都有统计学意义(P<.001)。经过最终评估,只有66例(16.6%)被诊断为CD,而212例患者(53.3%)有非特异性溃疡。大多数溃疡愈合的患者表现出与活动性回肠炎一致的病理结果。因此,可以得出结论,并非所有回肠终末溃疡都指示CD。在那些患有活动性回肠炎的病例中,应重新考虑重复结肠镜检查。
Terminal ileal ulcers can have various etiologies, including Crohn\'s disease (CD), infections, and medication-related causes. This study aims to investigate the incidence of terminal ileal ulcers detected during colonoscopies, explore their underlying causes, and analyze their clinical, endoscopic, and histopathological characteristics. Additionally, the study aims to identify predictive factors that indicate the need for follow-up. Medical records of all patients who underwent colonoscopies, between 2009 and 2019 were retrospectively reviewed. Patients with terminal ileal ulcers, with or without ileocecal valve involvement, were included in the study. Demographic information, medication usage, symptoms, colonoscopy findings, and histopathological data of these patients were analyzed. A total of 398 patients were included in the study. Histopathological examination revealed that 243 patients (61%) had active
ileitis, and 69 patients (17.4%) had chronic active
ileitis. The final diagnoses for ulcers were: nonspecific ulcers in 212 patients (53.3%), CD in 66 patients (16.6%), and non-steroidal anti-inflammatory drug-induced ulcers in 58 patients (14.6%). In the multivariate analysis, the parameters predicting CD included the presence of 10 or more ulcers (odds ratio (OR) = 7.305), deep ulcers (OR = 7.431), and edematous surrounding tissue (OR = 5.174), all of which were statistically significant (P < .001). Upon final evaluation, only 66 patients (16.6%) were diagnosed with CD, while 212 patients (53.3%) had nonspecific ulcers. The majority of patients with healed ulcers exhibited pathological findings consistent with active
ileitis. Therefore, it can be concluded that not all terminal ileal ulcers are indicative of CD. In those cases with active
ileitis, repetitive colonoscopies should be reconsidered.