Penetrating Crohn disease: does it occur in the absence of stricturing disease?
Penetrating Crohn disease: does it occur in the absence of stricturing disease?
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DOI：
10.1007/s00261-017-1398-7
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发表时间：
2018-07-01
影响因子：
2.4
通讯作者：
Trout, Andrew T.
中科院分区：
文献类型：
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作者：
Orscheln, Emily S.;Dillman, Jonathan R.;Trout, Andrew T.
目的：建立小儿克罗恩病(CD)穿透并发症与肠腔狭窄/狭窄疾病的关系。这项回顾性研究是IRB批准的，HIPAA符合知情同意的放弃。回顾2009年1月1日至2016年3月31日18岁CD患者的腹部穿透并发症的CT和MRI检查，以记录并发症的类型、受影响的肠段、最小肠腔直径、最大上行管径、穿透并发症相对于管腔狭窄的位置、肠段狭窄的长度以及是否存在活动性肠壁炎症。使用描述性统计方法对数据进行汇总，包括平均值、标准差以及计数和百分比。在45名患者中，共有52例穿透并发症被识别。患者平均年龄为15.7+/-2.2岁(11-18岁)，其中25/45(56%)为男孩。几乎所有穿透并发症(51/52，98%)都与最小肠腔直径(Ae)2 mm有关，其中26/52(50%)的肠腔看不见。平均最大上径2.8+/-0.8 cm(1.2~5.2 cm)，穿透并发症17/52(33%)与上径3 cm有关。平均最大/最小管径比值为26.2±8.8(3.6~52.0)。活动性肠炎与穿透并发症的发生率为100%(52/52)。几乎所有穿透性并发症(51/52，98%)都累及末端或远端回肠。儿童CD穿透性并发症几乎总是发生在管腔明显狭窄或狭窄和肠道炎症活跃的情况下。
To establish the relationship between penetrating complications and bowel luminal narrowing/stricturing disease in pediatric Crohn disease (CD).This retrospective study was IRB-approved and HIPAA compliant with waiver of informed consent. CT and MRI examinations describing intra-abdominal penetrating complications in CD patients ae 18 years old between January 1, 2009 and March 31, 2016 were reviewed to document: type of complication, affected bowel segment, minimum bowel luminal diameter, maximum upstream diameter, location of penetrating complication relative to luminal narrowing, length of narrowed bowel segment, and the presence of active bowel wall inflammation. Data were summarized using descriptive statistics including means, standard deviations, as well as counts and percentages.A total of 52 penetrating complications were identified in 45 patients. Mean patient age was 15.7 +/- 2.2 years (range 11-18 years) with 25/45 (56%) boys. Nearly all penetrating complications (51/52, 98%) were associated with a minimum bowel luminal diameter of ae 2 mm, with no visible lumen in 26/52 (50%). Mean maximum upstream diameter was 2.8 +/- 0.8 cm (range 1.2-5.2 cm), and 17/52 (33%) penetrating complications were associated with > 3 cm upstream diameter. The mean ratio of maximum to minimum luminal diameter was 26.2 +/- 8.8 (range 3.6-52.0). Active intestinal inflammation was associated with 100% (52/52) of penetrating complications. Nearly every penetrating complication (51/52, 98%) involved the terminal or distal ileum.Penetrating complications in pediatric CD nearly always occur in the setting of considerable luminal narrowing or stricture and active intestinal inflammation.