Colonoscopic differences of erosive and/or small ulcerative lesions for diagnosis of colonic inflammatory diseases.
OBJECTIVE
Various etiologies and diseases may be related to erosive and/or small ulcerative lesions without gross appearance in the colon during colonoscopy. However, few investigators report on differential diagnosis of colonic inflammatory diseases. Thus, we investigated the clinical significance of these lesions and the value of colonoscopy in the differential diagnosis of colitis.


METHODS
In 110 patients with erosive and/or small ulcerative lesions (<5 mm) who were treated in our hospital during the past 9 years, we retrospectively investigated the relationship between endoscopic morphology and clinical diagnosis. The intestinal lesions were endoscopically classified into three groups (A, hyperemic type; B, aphthous type; and C, verrucous type).


RESULTS
The lesions were mainly located in the rectum to the sigmoid colon in group A. In group C, the lesions were most frequently located in the transverse colon and deeper areas. Endoscopically, the etiology was unclear in 74.5% of group A and 73.8% of group B, however, in group C, most of them (81.0%) were associated with specific diseases. With respect to inflammatory bowel diseases, 71.4% of the patients with Crohn's disease and all patients with ulcerative colitis were assigned to group A or B.


CONCLUSIONS
Erosive and/or small ulcerative lesions belonging to group A or B were mainly non-specific. However, careful follow up was required in groups A and B, which included the possibility of inflammatory bowel diseases, when the symptoms or lesions were not improved.
Inoue
Takuya
T
Second Department of Internal Medicine, Osaka Medical College, Takatsuki City, Osaka, Japan.
Murano
Mitsuyuki
M
Abe
Yosuke
Y
Morita
Eijiro
E
Murano
Naoko
N
Toshina
Ken
K
Umegaki
Eiji
E
Hirata
Ichiro
I
Higuchi
Kazuhide
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003092:Colitis / Q000175:diagnosis* / Q000473:pathology; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000473:pathology; D003106:Colon / Q000473:pathology*; D012809:Colon, Sigmoid / Q000473:pathology; D003113:Colonoscopy; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012007:Rectum / Q000473:pathology; D012189:Retrospective Studies; D014741:Video Recording; D055815:Young Adult