Clinical features of Crohn's disease at different location / 中华消化内镜杂志

ABSTRACT

Objective To study the clinical features of Crohn's disease(CD)at different location,I.e.small intestine.colon and ileocolon,to facilitate the knowledge of the disease.Methods Data of 103 patients,hospitalized to our department from 2000 to January 2008,were retrospectively analyzed,including general status,clinical manifestations,laboratory findings and pathological changes.Results The cohort included 70 males and 33 females,with the age when the diagnosis was confirmed ranging from 12 to 70,with a peak at 20-29 yr.The location of the main lesion was at small bowel(L1)in 39(38%),at colon (L2)in 16(16%)and at ileum-colon(L3)48(46%).There was no significant difference between each group,regarding the age of onset or the when the diagnosis was confirmed.The incidence of intestinal obstruction was higher in L1 patients than that in L3(P＜0.05).In group L1,12(30.8%)were diagnosed by capsule endoscopy,and 17(44%)were confirmed by colonoscopy.Diagnostic rates of L2 and L3 with reference to clinical manifestations.combined with colonoscopy and pathology were 87.5%and 83.3%,respectivelv.In this cohort,there were 23(22.3%)mild cases,58(56.3%)moderate cases and 22 (21.4%)severe cases,according to simplified CD activity index(CDAI).The rate of severe case in L3 was 59.0%(13/48),which was significantly higher than that in L1(P＜0.05).Conclusion In patients with CD,L1 is characterized by delayed diagnosis and need of emergent surgery,while L3 is featured with extensive involvement.severe complications and systemic manifestations.Severe case is common in 13 patient,capsule endoscopy and Colonoscopy are important in early detection of the disease to decrease operation rate and delay the time of first operation.