[Importance of colonoscopy combined with biopsy in the diagnosis of colonic Crohn's disease].
OBJECTIVE
An attempt was made to provide a better insight into endoscopic and histological features and/or problems encountered when establishing a diagnosis of colonic Crohn's disease (Crohn's colitis).


METHODS
As presented in our 27 cases with Crohn's colitis, the endoscopic findings and histological changes of biopsy specimens were summarized. As collated with correspondent results of biopsy and surgical specimens, the diagnostic accuracy of endoscopy was evaluated.


RESULTS
twenty-six involvements of the large intestine (combined with other sites of the intestine) was found (96.3%). However, involvement limited to the colon alone was seen in only 4 cases (14.8%). Endoscopically, overlapped lesions with multistaged-segmental distributed and multi-sited diverse patterns (destructive and proliferative/regenerative) of inflammatory changes were observed. Endoscopic accuracy was 66.7%. The characteristic features of mucosal biopsy include focal distribution of the lesions, a thickened and edematous submucosa, deep fissuring ulcers, lymphoid aggregate, and hyperplasia, fibrosis and granulomas (detected in 30% of the group), etc.


CONCLUSIONS
Colonic involvement of Crohn's disease is common. Colonoscopy may be valuable in establishing the diagnosis and in assessing the extent and severity of colonic involvement, and CDEIS was value in the follow up of patients. Colonoscopic biopsies are helpful for verification of the diagnosis in difficult cases. Colonoscopy has replaced radiology as the initial test of choice in many clinical situations.
Zheng
Jia-ju
JJ
Department of Gastroenterology of the Third People's Hospital of Suzhou, Suzhou 215008, China.
Chu
Xing-qi
XQ
Shi
Xiao-hua
XH
Wang
Yu-ming
YM
Jia
Li-ming
LM
Zhou
Chun-li
CL
Wang
Feng-ming
FM
D001706:Biopsy; D003106:Colon / Q000473:pathology*; D003113:Colonoscopy; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male