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.
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.
Authors: Hyun Seok Lee; Yun Jeong Lim; Ki Nam Shim; Chang Mo Moon; Hyun Joo Song; Jin Oh Kim; Seong Ran Jeon; Dae Young Jung; Ji Hyun Kim; Kyeong Ok Kim; Bo-In Lee Journal: Dig Dis Sci Date: 2016-11-26 Impact factor: 3.199