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The Characteristics of Colonoscopic Findings in Differentiating Crohn's Disease from Intestinal Tuberculosis
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In Soo Je, Sang Hyuk Lee, Eun Uk Jung, Myoung Joo Kang, Sang Won Park, Paul Choi, Ji Hyun Kim, Sung Jae Park, Sam Ryong Jee, Eun Taek Park, Youn Jae Lee, Sang Yong Seol
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Intest Res 2007;5(2):158-164. Published online December 30, 2007
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 Abstract
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- Background/Aims
The incidence of Crohn's disease (CD) is on the increase in Korea. The differentiation of Crohn's disease from intestinal tuberculosis (IT) is difficult. The aim of this study is to determine the characteristics of colonoscopic findings and factors that differentiate CD from IT. Methods: A total of 136 patients who were diagnosed with CD or IT at the Busan Paik Hospital from January 1995 to May 2005 were included in this study. We analyzed endoscopic findings, clinical characteristics and histological findings of 75 patients with CD and 61 patients with IT retrospectively. Results: For patients with IT, 18 (58.1%) of the patients had circular ulcers. For patients with CD, 27 (42.1%) of the patients had transverse ulcers, 18 (28.1%) of the patients had longitudinal ulcer, and 19 (29.6%) of the patients had both types of ulcers. The involvement of the ileocecal valve was noted in 18 (58.0%) of the patients with CD and in 37 (57.8%) of the patients with IT. The involvement of the rectum or anus was noted in 24 (51.5%) of the patients with CD and one (3.2%) patient with IT. Conclusions: According to previous studies, the presence of an ulcer was important to differentiate CD from IT. However, the presence of an ulcer was not a significant differentiating factor in our study. On colonoscopic findings, involved segments, an aphthous ulcer, cobblestone appearance, involvement of the rectum or anus and mucosal bridge should be observed carefully. (Intest Res 2007;5:158-164)
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