Colonoscopic and histologic features of colonic Crohn's disease in Chinese patients.
OBJECTIVE
An attempt was made to provide a better insight into endoscopic and histological features and to enhance the understanding of the diagnostic value of colonoscopy combined with biopsy for colonic Crohn's disease.


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


RESULTS
Of these patients, 26 involvements of the colon (often combined with other sites of the bowel) were observed (96.3%). However, involvements limited to the colon alone were seen in only four cases (14.8%). Endoscopically, diverse patterns of multi-staged-segmental distributed and multi-sited inflammatory lesions, both destructive and proliferative/regenerative changes were observed in the bowel of the same patient. The diagnostic accuracy of colonoscopy, as confirmed by the histological examination of biopsy and resected specimens, was 66.7%. The major characteristic features of mucosal biopsy were the focal distribution of inflammatory infiltration and lymphoid aggregate. Otherwise, it may include edematous and widened submucosa, deep fissuring ulcers and hyperplasia, fibrosis and granulomas (detected in 30% of the group), among others.


CONCLUSIONS
The colonic involvement of Crohn's disease was common. Colonoscopy may be valuable in establishing a diagnosis and in assessing the extent and severity of such colonic involvement. Biopsy is helpful to confirm a diagnosis conducted by colonoscopy. Colonoscopy combined with biopsy may replace radiology as the initial test of choice in many clinical situations.
Zheng
Jia Ju
JJ
Department of Gastroenterology, Suzhou Municipal Hospital, Suzhou, China. zhengjj2218@163.com
Cu
Xing Qi
XQ
Shi
Xiao Hua
XH
Wang
Yu Ming
YM
Jia
Li Ming
LM
Zhou
Xun Li
XL
Wang
Fong Ming
FM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002681:China; D003092:Colitis / Q000473:pathology*; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D003424:Crohn Disease / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged