Juan Du1, Haojie Du1, Hongtan Chen1, Lingyan Shen2, Bingling Zhang1, Weiwei Xu3, Zhongchen Zhang4, Chunxiao Chen5. 1. Department of Gastroenterology, Zhejiang University School of Medicine First Affiliated Hospital, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China. 2. Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, Taizhou, Zhejiang, China. 3. Department of Endocrinology, Zhejiang University School of Medicine First Affiliated Hospital, Zhejiang, China. 4. Department of Gastroenterology, Wenling First People's Hospital, Wenling, China. 5. Department of Gastroenterology, Zhejiang University School of Medicine First Affiliated Hospital, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China. 1184003@zju.edu.cn.
Abstract
BACKGROUND: Previous studies suggest that Crohn's disease (CD) with both small bowel and colon involvement is more serious than colonic CD. However, clinical features of isolated small-bowel CD have not been fully investigated. METHODS: In this retrospective case-control study, 89 patients were divided into two groups according to capsule endoscopy, ileocolonoscopy, and enhanced computed tomography results. The case group was isolated small-bowel CD (n = 50) and the control group was CD with both small bowel and colon involvement (n = 39). We collected data of the patients and analyze it. RESULTS: In univariate analysis, isolated small-bowel CD group had higher percentage of stricture, Lewis score, platelet, plateletcrit and lower Harvey-Bradshaw index, high-sensitivity C-reactive protein, and erythrocyte sedimentation rate. In multivariable analysis, it had lower Harvey-Bradshaw index (p = 0.000), which meaned relatively mild symptoms. However, it had higher Lewis score (p = 0.007), which meaned more serious small-bowel inflammation. The Kaplan-Meier survival curve also suggested that isolated small-bowel CD patients were more likely to accept partial small intestinal resection surgery (p = 0.029). CONCLUSIONS: Isolated small-bowel CD is easily overlooked for milder clinical symptoms and relatively limited lessions, but severe small-bowel histological injury results in owing worse clinical outcomes. Clinicians should pay more attention to the isolated small-bowel CD and take aggressive intervention during therapy.
BACKGROUND: Previous studies suggest that Crohn's disease (CD) with both small bowel and colon involvement is more serious than colonic CD. However, clinical features of isolated small-bowel CD have not been fully investigated. METHODS: In this retrospective case-control study, 89 patients were divided into two groups according to capsule endoscopy, ileocolonoscopy, and enhanced computed tomography results. The case group was isolated small-bowel CD (n = 50) and the control group was CD with both small bowel and colon involvement (n = 39). We collected data of the patients and analyze it. RESULTS: In univariate analysis, isolated small-bowel CD group had higher percentage of stricture, Lewis score, platelet, plateletcrit and lower Harvey-Bradshaw index, high-sensitivity C-reactive protein, and erythrocyte sedimentation rate. In multivariable analysis, it had lower Harvey-Bradshaw index (p = 0.000), which meaned relatively mild symptoms. However, it had higher Lewis score (p = 0.007), which meaned more serious small-bowel inflammation. The Kaplan-Meier survival curve also suggested that isolated small-bowel CDpatients were more likely to accept partial small intestinal resection surgery (p = 0.029). CONCLUSIONS: Isolated small-bowel CD is easily overlooked for milder clinical symptoms and relatively limited lessions, but severe small-bowel histological injury results in owing worse clinical outcomes. Clinicians should pay more attention to the isolated small-bowel CD and take aggressive intervention during therapy.
Entities:
Keywords:
Capsule endoscopy; Colon; Inflammatory bowel disease; Small bowel
Authors: I M Gralnek; R Defranchis; E Seidman; J A Leighton; P Legnani; B S Lewis Journal: Aliment Pharmacol Ther Date: 2007-10-23 Impact factor: 8.171
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