title: A Bamboo Joint-Like Appearance is a Characteristic Finding in the Upper Gastrointestinal Tract of Crohn's Disease Patients: A Case-Control Study.
abstract: The clinical importance of Crohn's disease (CD)-specific lesions in the upper gastrointestinal tract (upper GIT) has not been sufficiently established. The aim of this case-control study is to investigate the characteristic findings of CD in the upper GIT. In 2740 patients who underwent gastroduodenoscopy at Asahikawa Medical University between April 2011 and December 2012, 81 CD patients, 81 gender- and age-matched non-IBD patients, and 66 ulcerative colitis (UC) patients were investigated in the present study. (1) The diagnostic ability and odds ratio of each endoscopic finding (a bamboo joint-like appearance in the cardia, erosions, and/or ulcers in the antrum, notched signs, and erosions and/or ulcers in the duodenum) were compared between the CD and non-IBD patients or UC patients. (2) The interobserver agreement of the diagnosis based on the endoscopic findings was evaluated by 3 experienced and 3 less-experienced endoscopists. The incidence of detecting a bamboo joint-like appearance, notched signs, and erosions and/or ulcers in the duodenum was significantly higher in the CD patients than in the non-IBD and UC patients. In addition, the diagnostic ability and odds ratio of a bamboo joint-like appearance for CD were higher than those for the other findings. Kendall's coefficients of concordance in the group of experienced and less-experienced endoscopists were relatively high for a bamboo joint-like appearance (0.748 and 0.692, respectively). A cardiac bamboo joint-like appearance is a useful finding for identifying high-risk groups of CD patients using only gastroduodenoscopy.
authors.affiliation: From the Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University (MF, AS, TD, KT, KA, NU, TG, SK, MT, YI, TI, KM, HT, KI, TO, YK); Department of Gastroenterology, Yoshida Hospital (KY); Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine (JW); and Digestive Disease Center, Asahikawa City Hospital (YS).
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Fujiya
authors.forename: Aki
authors.initials: A
authors.lastname: Sakatani
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Dokoshi
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Tanaka
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Ando
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ueno
authors.forename: Takuma
authors.initials: T
authors.lastname: Gotoh
authors.forename: Shin
authors.initials: S
authors.lastname: Kashima
authors.forename: Motoya
authors.initials: M
authors.lastname: Tominaga
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Inaba
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ito
authors.forename: Kentaro
authors.initials: K
authors.lastname: Moriichi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tanabe
authors.forename: Katsuya
authors.initials: K
authors.lastname: Ikuta
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ohtake
authors.forename: Kinnichi
authors.initials: K
authors.lastname: Yokota
authors.forename: Jiro
authors.initials: J
authors.lastname: Watari
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Saitoh
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D003424:Crohn Disease / Q000473:pathology*; D004384:Duodenoscopy; D004386:Duodenum / Q000473:pathology*; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D013270:Stomach / Q000473:pathology*; D055815:Young Adult