An analysis of misdiagnosed Crohn's disease in China / 中华消化内镜杂志

ABSTRACT

Objective In order to improve the diagnostic level of Crohn's disease( CD),the relevant literatures with CD in China were reviewed and the causes of misdiagnosis about CD were analyzed. Methods Papers on CD published in medical journals from 1989 to 2003 in CMCC and VIP are collected and reviewed one by one, and then the characteristics of the misdiagnosed and missed CD were recorded and the causes of these cases were analyzed. Results From 1989 to 2003, there are 428 papers about CD, of which 261 papers are about clinical studies(60.9%); In these papers, total of 3397 CD cases were reported. In these cases there are 2357 cases missed, clinical symptoms are various and complex including abdomen pain (62.5%),diarrhea(51.5%), abdomenal lumps(16.6%) and so on. The most commonly involved sites of CD are terminal ileum (62.5%), colon (26.9%) and ileum combining with colon (38.9%). Cranulomas were identified in 61.2% of operative specimens and in 27.6% of biopsy specimens. The most common missed diagnosed diseases are intestinal tuberculosis(32. 2% ), simplex intestinal block (23.2%) and intestinal block caused by tumor(6.4%) and acute appenditis(27. 9% ). There are 389 cases misdiagnosed as CD, the most common diseases are tuberculosis(53.5%), small intestinal lymphoma(14.4%) and colonal cancer (17.0%). Conclusion Papers on CD are increased gradually during the periods from 1989 to 2003 with rather high missed or misdiagnosis. As a result, it is necessary for us to improve the cognitzability on CD and to improve the accuracy of diagnosis.