[Clinical significance of erosive and/or small ulcerative lesions in the colon and terminal ileum--short-term follow-up study].
OBJECTIVE
Various etiologies and diseases may be related to erosions and/or small ulcers without gross inflammatory changes in the surrounding mucosa found in the colon and terminal ileum during colonoscopy. However, studies on follow-up of these lesions are rare. Thus, we investigated the clinical significance of these lesions and their characteristics helpful for differential diagnosis.


METHODS
We reviewed the data of 183 patients with colonoscopically observed erosive or small ulcerative lesions (<2 cm), and analyzed them according to the location, number, and size of lesions, histopathologic findings, chief complaints, laboratory findings, changes of symptoms, and changes in lesions during 4-12 week follow-up period.


RESULTS
Histopathologic findings of these lesions included acute nonspecific inflammation, chronic nonspecific inflammation, Crohn's disease, tuberculous colitis, ischemic colitis, Behcet's disease, cytomegalovirus infection, eosinophilic colitis, ulcerative colitis or pseudomembranous colitis, but most of them were nonspecific (84%). In patients with nonspecific inflammation, histopathologic findings, symptoms, location and multiplicity of the lesions were not prognostic factors for the persistency of symptoms and lesions during follow-up period. Two patients with acute inflammation, who showed no improvement in symptoms and lesions, were later diagnosed as Crohn's disease.


CONCLUSIONS
Erosive or small ulcerative lesions without macroscopic inflammatory changes in the surrounding mucosa during colonoscopy, are mainly nonspecific. However, careful follow-up is required when the symptoms and/or lesions are not improved.
Kim
Doh Hyun
DH
Department of Internal Medicine, Ajou University School of Medicine, Suwon 443-721, Korea.
Lee
Kwang Jae
KJ
Kim
Yeong Bae
YB
Lee
Eun Hee
EH
Song
Hyun Ju
HJ
Kim
Jin Hong
JH
Hahm
Ki Baik
KB
Cho
Sung Won
SW
D000293:Adolescent; D000328:Adult; D000368:Aged; D003106:Colon / Q000473:pathology*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology*; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014456:Ulcer / Q000473:pathology