Clinical and colonoscopic characteristics of Crohn disease and intestinal tuberculosis
10.3760/cma.j.issn.1007-5232.2012.06.009
- VernacularTitle:回结肠克罗恩病与肠结核临床及内镜特征比较
- Author:
Yao HE
;
Yujun CHEN
;
Hong YANG
;
Renwei HU
;
Chunhui OUYANG
;
Meifang HUANG
;
Wangdi LIAO
;
Jiaming QIAN
;
Qin OUYANG
;
Xiaoping WU
;
Bing XIA
;
Nonghua Lü
;
Pinjin HU
- Publication Type:Journal Article
- Keywords:
Crohn disease;
Intestinal tuberculosis;
Endoscopic characteristics;
Clinical features
- From:
Chinese Journal of Digestive Endoscopy
2012;29(6):325-328
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo unify the definitions of colonoscopic characteristics of Crohn disease (CD) and intestinal tuberculosis ( ITB),and to evaluate colonoscopic and clinical features in the differential diagnosis of CD and ITB.MethodsA collaborative group composed of 10 experts from 5 hospitals voted to identify and confirm the colonoscopic characteristics.Clinical and colonoscopic characteristics were analyzed,thereafter,characteristics were scored based on different diagnostic specificity.ROC curve was used for determining the cutoff point to differentiate CD from ITB.ResultsFirstly,standard endoscopic images and descriptions were determined.Secondly,colonoscopic parameters which were significantly different between the CD and ITB patients included the follows:involvement of more than four intestinal segments,anorectal involvement,longitudinal ulcers,cobblestone appearance and transverse ulcers.Clinical findings which were significantly different between the CD and ITB patients included active pulmonary tuberculosis,PPD-test strong positive,anal fistula/perianal abscess and extra-intestinal manifestations in CD.4.4％(6/136) patients were confirmed by histological evidence of caseating granulomas.By using our scoring system,39.7％ (54/136) confirmed diagnoses and 18.4％ (25/136) suspected diagnoses were made in patients without histological evidence.ConclusionIdentification of colonoscopic characteristics and unification of the colonscopic diagnostic criteria were helpful in the differential diagnosis between CD and ITB.The differential diagnosis rate could he improved by using the scoring system.Half cases could not be confirmed even with combined pathology and the scoring system,so a more comprhensive scoring system would be warranted.
