Isolated terminal ileal ulcerations in asymptomatic individuals: natural course and clinical significance.
BACKGROUND
Although isolated terminal ileal ulcerations (ITIUs) are occasionally observed on colonoscopic examination of asymptomatic individuals, their clinical course and guidelines for treatment are unclear.


OBJECTIVE
To evaluate the clinical course and significance of ITIUs in asymptomatic individuals.


METHODS
Single-center retrospective analysis.


METHODS
University hospital.


METHODS
All patients diagnosed with ITIUs on colonoscopy from July 2001 to December 2007 were identified. Patients with colorectal symptoms, a history of nonsteroidal anti-inflammatory drug consumption, a history of colorectal surgery, oral or genital ulcerations, and coincidental ulceration in the ileocecal valve or colon were excluded.


METHODS
Colonoscopic findings and clinical courses of patients were analyzed.


RESULTS
Of the 148 included patients, 93 were followed (mean duration, 29.9 months). Of these, 62 showed resolution of ITIU on follow-up colonoscopy, including 60 who resolved without any treatment and 2 who resolved after antituberculosis medication. Follow-up colonoscopy continued to show ITIUs in the remaining 31 patients, only 1 of whom developed typical Crohn's disease, whereas the other 30 showed no significant changes in the lesions (n = 22), partial improvement (n = 6), or waxing and waning endoscopic appearance (n = 2).


CONCLUSIONS
Retrospective design, relatively short-term follow-up.


CONCLUSIONS
Most ITIUs incidentally observed in asymptomatic individuals resolve without any treatment. Even if these lesions persist, it is unusual for them to progress or to cause any symptoms.
Health Promotion Center, University of Ulsan College of Medicine, Seoul, Korea.
Hye-Sook
HS
Chang
Don
D
Lee
Jong Cheol
JC
Kim
Hye-Kyung
HK
Song
Hyun Ju
HJ
Lee
Eun-Ju
EJ
Chung
Tae Hyup
TH
Kim
Hye-Won
HW
Park
Jeong-Sik
JS
Byeon
Suk-Kyun
SK
Yang
Jae-Won
JW
Choe
D000328:Adult; D000368:Aged; D001706:Biopsy; D003113:Colonoscopy; D003424:Crohn Disease / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis* / Q000473:pathology; D007082:Ileum / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D014456:Ulcer / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult