| Clinical Significance of Erosive or Ulcerative Lesions Isolated in Terminal Ileum |
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Sun Ok Kwon, You Sun Kim, Myoung Ki Oh, Sun Young Kim, In Hye Cha, Seong Yeon Jeong, Joo Yeon Cho, Jin Nam Kim, Jeong Seop Moon |
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Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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| 말단 회장에 국한된 미란 혹은 궤양 병변의 임상적 의의 |
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권선옥, 김유선, 오명기, 김선영, 차인혜, 정성연, 조주연, 김진남, 문정섭 |
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인제대학교 의과대학 서울백병원 내과학교실 |
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| Abstract |
Background/Aims
Although terminal ileal erosive or ulcerative lesions are frequently observed on colonoscopic examination, their clinical significance are unclear. We evaluated clinical course and significance of isolated terminal ileal erosive or ulcerative lesions. Methods: We retrospectively analyzed clinical features, number, size and histologic findings of 186 patients with isolated terminal ileal erosive or ulcerative lesions on colonoscopic examination from December 2003 to February 2012. Results: The indications for colonoscopy included screening for colorectal cancer or surveillance in 122 patients (65.6%), evaluations for symptoms in 64 patients (34.4%). Of the 186 patients, 170 underwent biopsy at the terminal ileal lesions. Histologic findings were mostly non-specific chronic inflammation except two cases of Crohn's disease, one case of cytomegalovirus ileitis, and one case of intestinal tuberculosis. Forty six patients underwent follow-up colonoscopy and the mean duration was 17.8±14.2 months (range, 1-64 months). Of those who showed non-specific ileitis (44 patients), 35 (79.5%) showed resolution of lesions without specific treatment. In the remaining 9 (20.5%) patients, lesions were continued and two patients were diagnosed as Crohn's disease and Behcet's ileitis, respectively. There were no significant differences in the duration of follow-up, presence of symptoms, number and size of terminal ileal lesions between the patients who resolved and not resolved. Conclusions: Most isolated terminal ileal erosive or ulcerative lesions reveal non-specific histological findings and have a propensity to resolve without treatment. However, in small portions of patients, isolated terminal ileal lesions need careful attention because it is possible to be early inflammatory bowel diseases. (Intest Res 2012;10:350-356) |
| Key Words:
Colonoscopy, Terminal ileum, Histology, Crohn disease |
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