Isolated terminal ileal ulcerations in asymptomatic individuals: natural course and clinical significance
Isolated terminal ileal ulcerations in asymptomatic individuals: natural course and clinical significance
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DOI：
10.1016/j.gie.2010.08.029
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发表时间：
2010-12-01
影响因子：
7.7
通讯作者：
Choe, Jae-Won
中科院分区：
文献类型：
--
作者：
Chang, Hye-Sook;Lee, Don;Choe, Jae-Won
背景：虽然在无症状个体的结肠镜检查中偶尔观察到孤立性回肠末端溃疡（ITIU），但其临床病程和治疗指南尚不清楚。目的：评估无症状个体中 ITIU 的临床病程和意义。设计：单中心回顾性分析。地点：大学医院。患者和干预措施：确定 2001 年 7 月至 2007 年 12 月期间经结肠镜检查诊断为 ITIU 的所有患者。排除有结直肠症状、非甾体类抗炎药服用史、结直肠手术史、口腔或生殖器溃疡以及回盲瓣或结肠同时发生溃疡的患者。主要结果测量：分析患者的结肠镜检查结果和临床病程。结果：在 148 例纳入的患者中，有 93 例得到随访（平均持续时间为 29.9 个月）。其中，62 例在随访结肠镜检查中显示 ITIU 消退，其中 60 例无需任何治疗即可消退，2 例在抗结核药物治疗后消退。其余 31 名患者的随访结肠镜检查继续显示 ITIU，其中只有 1 名患者出现典型的克罗恩病，而其他 30 名患者则显示病变无明显变化（n = 22）、部分改善（n = 6）或内镜外观消退（n = 2）。 局限性：回顾性设计，随访时间相对较短。结论：大多数在无症状个体中偶然观察到的 ITIU 都消失了，没有任何症状。治疗。即使这些病变持续存在，它们也不会进展或引起任何症状。 (Gastrointest Endose 2010；72:1226-32。)
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. (Gastrointest Endose 2010;72:1226-32.)