PURPOSE: We evaluated the risk factors for late complications and functional outcome after total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). METHODS: Pre- and postoperative clinical status and follow-up data were obtained for 55 patients who underwent TPC with IPAA between 1999 and 2010. The median follow-up duration was 4.17 years. Late complications were defined as those that appeared at least one month after surgery. For a functional assessment, telephone interviews were conducted using the Global Assessment of Functioning Scale. Twenty-eight patients completed the interview. RESULTS: Late complications were found in 20 cases (36.3%), comprising pouchitis (n = 8), bowel obstruction (n = 5), ileitis (n = 3), pouch associated fistula (n = 2), and intra-abdominal infection (n = 2). The preoperative serum albumin level for patients with late complications was lower than for patients without (2.4 +/- 0.5 vs. 2.9 +/- 0.7, P = 0.04). Functional outcomes were not significantly associated with clinical characteristics, follow-up duration, operation indication, or late complications. CONCLUSION: This study demonstrated that a low preoperative albumin level could be a risk factor for late complications of TPC with IPAA. Preoperative nutritional support, especially albumin, could reduce late complications. Functional outcomes are not related to late complications.
Colitis, Ulcerative ; Fistula ; Follow-Up Studies ; Humans ; Ileitis ; Interviews as Topic ; Intraabdominal Infections ; Nutritional Support ; Pouchitis ; Risk Factors ; Serum Albumin ; Ulcer

Behcet's disease is a disorder of a multisystemic involvement with unknown etiology. Involvement of the cardiovascular system and intestinal tract are rare, but serious complications. We present a case with Behcet's disease demonstrating aneurysm of the abdominal aorta as well as hemorrhagic ileal ulcerative lesions and requiring surgical treatment.
Aneurysm* ; Aorta, Abdominal* ; Aortic Aneurysm ; Behcet Syndrome ; Cardiovascular System ; Ileitis ; Ileum* ; Ulcer*

A case of rather typical Crohn's disease in a 10 year old girl is described. She had suffered from intractable abdominal pain, diarrhea and fever for 1 year. Eventual right hemicolectomy revealed diffuse involvement of terminal ileum, cecum and ascending colon by confluent ulcerations and transmural inflammation. Histologically there were numerous well developed non-caseating granulomas scattered transmurally and in regional lymph nodes. Deep penetrating ulcerations were characteristic. Acid fast staining failed to demonstrate any organism. The rarity of Crohn's disease in Korea and this occurrence in pediatric age prompted this report.
Child ; Colitis/pathology ; Crohn Disease/diagnosis/*pathology ; Diagnosis, Differential ; Female ; Granuloma/pathology ; Humans ; Ileitis/pathology ; Intestines/pathology

PURPOSE: Porcine proliferative enteropathy (PPE) is known as one of the most important risk factors causing economic losses in swine industry worldwide. This study was conducted to evaluate the efficacy of a commercial oral attenuated Lawsonia intracellularis vaccine (Enterisol Ileitis) against PPE under a commercial pig farm condition in Korea. MATERIALS AND METHODS: Thirty two-day-old 672 piglets were randomly allocated into vaccinated and control groups. All piglets in the vaccinated group were inoculated with a commercial attenuated L. intracellularis vaccine as following the manufacturer's instruction. Body weights of all pigs in both groups were measured on the vaccination day and 6, 14, and 20 weeks post vaccination and an average daily weight gain (ADWG) was calculated. Health status was observed biweekly during the whole trial. RESULTS: The vaccinated group showed significantly higher body weight (p<0.05) and ADWG (p<0.05) than those of the control group. The vaccinated group had significantly reduced impairments in activity, growth, defecation frequency, and stool hardness (p<0.05). Additional health benefits and improved weight gain by the vaccination produced a 4.2:1 return of investment, and the higher gross margin was $4.80 per pig. CONCLUSION: Our finding suggests that the L. intracellularis vaccine program has effects on the substantial health and economic benefits in the Korean swine industry.
Body Weight ; Defecation ; Hardness ; Ileitis ; Insurance Benefits ; Intestinal Diseases ; Investments ; Korea ; Lawsonia Bacteria ; Risk Factors ; Swine ; Vaccination ; Vaccines ; Weight Gain

Typhoid fever frequently manifests as gastrointestinal complications, such as ileitis or colitis, but appendicitis is quite rare. A 37-year-old man was admitted due to abdominal pain, fever and diarrhea. Two weeks before admission, he underwent an appendectomy. The blood culture upon admission revealed Salmonella Typhi. A polymerase chain reaction(PCR) was performed on the tissue of the vermiform appendix and the STY0312 gene of S. Typhi was detected. This is the first case of acute appendicitis complicated with typhoid fever proven by PCR in Korea.
Abdominal Pain ; Appendectomy ; Appendicitis ; Appendix ; Colitis ; Diarrhea ; Fever ; Ileitis ; Korea ; Polymerase Chain Reaction ; Salmonella ; Salmonella typhi ; Typhoid Fever

Yersinia enterocolitica, a gram-negative rod-like organism, has been recognized as an uncommon human pathogen producing a wide spectrum of clinical manifestations. It has been associated with gastroenteritis, acute ileitis, mesenteric lymphadenitis, and erythema nodosum. More recently polyarthritis, chronic arthritis, and Reiter syndrome have been related to previous infection with these organism. Liver and splenic abscesses have been found rarely in Yersinia enterocolitica bactermia, and these have not been reported yet in Korea. We report a case of multiple liver and splenic abscesses secondary to Yersinia enterocolitica septisemia in a chronic renal failure patient on hemodialysis.
Abscess* ; Arthritis ; Arthritis, Reactive ; Erythema Nodosum ; Gastroenteritis ; Humans ; Ileitis ; Kidney Failure, Chronic* ; Korea ; Liver* ; Mesenteric Lymphadenitis ; Renal Dialysis* ; Sepsis* ; Spleen* ; Yersinia enterocolitica* ; Yersinia*

PURPOSE:Benign anorectal disease will often cause great concern to the patient and the practitioner about a more proximal colon pathology. The aim of this study is to evaluate the significance of routine colonoscopy for patients with benign anorectal disease. METHODS:A retrospective analysis of 108 patients with benign anorectal disease who had undergone colonoscopic examination from April 1997 to August 1998 at Gil Medical Center was done. RESULTS:The mean age of all patients was 43 years; the male-to-female ratio was 1:1.1. The diagnoses of anorectal disease were hemorrhoids in 84 cases, anal fissures in 13 cases, chronic anal pain syndrome in 6 cases, anorectal fistulas in 5 cases, and other in 9 cases. There were 37 patients (34.3%) with 53 abnormal findings:14 tubular adenomas, 11 inflammatory polyps, 4 hyperplastic polyps, 1 tuberculous colitis, 1 angiodysplasia, 6 diverticula, 6 nonspecific ileitis or colitis, 2 melanosis coli, 2 rectal ulcers, 2 ileal ulcers, and 3 other diseases. Among them, clinically significant lesions, such as neoplastic lesion, tuberculous colitis and angiodysplasia, were detected in 12 patients (11.1%). Because the lesions in 7 patients of the 12 patients were within the reach of sigmoidoscopy, only 5 patients (4.6%) needed a colonoscopic examination. In regard to neoplasms, patients presenting with anal bleeding and old age were not found to have a higher frequency of neoplasia. Also, the specific type of anorectal disease was not associated with an increased risk for colorectal neoplasia (P>0.05). CONCLUSIONS:Sigmoidoscopy is a more acceptable primary diagnostic tool in patients with benign anorectal disease, but in patients with gastrointestinal symptoms, a high risk for colorectal cancer, suspicious inflammatory bowel disease, or fear of cancer, selective colonoscopy will be needed.
Adenoma ; Angiodysplasia ; Colitis ; Colon ; Colonoscopy* ; Colorectal Neoplasms ; Diagnosis ; Diverticulum ; Fistula ; Hemorrhage ; Hemorrhoids ; Humans ; Ileitis ; Inflammatory Bowel Diseases ; Melanosis ; Pathology ; Polyps ; Retrospective Studies ; Sigmoidoscopy ; Ulcer

BACKGROUND/AIMS: Although terminal ileal erosive or ulcerative lesions are frequently observed on colonoscopic examination, their clinical significance are unclear. We evaluated clinical course and significance of isolated terminal ileal erosive or ulcerative lesions. METHODS: We retrospectively analyzed clinical features, number, size and histologic findings of 186 patients with isolated terminal ileal erosive or ulcerative lesions on colonoscopic examination from December 2003 to February 2012. RESULTS: The indications for colonoscopy included screening for colorectal cancer or surveillance in 122 patients (65.6%), evaluations for symptoms in 64 patients (34.4%). Of the 186 patients, 170 underwent biopsy at the terminal ileal lesions. Histologic findings were mostly non-specific chronic inflammation except two cases of Crohn's disease, one case of cytomegalovirus ileitis, and one case of intestinal tuberculosis. Forty six patients underwent follow-up colonoscopy and the mean duration was 17.8+/-14.2 months (range, 1-64 months). Of those who showed non-specific ileitis (44 patients), 35 (79.5%) showed resolution of lesions without specific treatment. In the remaining 9 (20.5%) patients, lesions were continued and two patients were diagnosed as Crohn's disease and Behcet's ileitis, respectively. There were no significant differences in the duration of follow-up, presence of symptoms, number and size of terminal ileal lesions between the patients who resolved and not resolved. CONCLUSIONS: Most isolated terminal ileal erosive or ulcerative lesions reveal non-specific histological findings and have a propensity to resolve without treatment. However, in small portions of patients, isolated terminal ileal lesions need careful attention because it is possible to be early inflammatory bowel diseases.
Biopsy ; Colonoscopy ; Colorectal Neoplasms ; Crohn Disease ; Cytomegalovirus ; Follow-Up Studies ; Humans ; Ileitis ; Ileum ; Inflammation ; Inflammatory Bowel Diseases ; Mass Screening ; Retrospective Studies ; Tuberculosis ; Ulcer

The major causes of terminal ileitis are inflammatory bowel disease and NSAIDs but parasites such as Anisakis rarely induce ileitis. Ascaris lumbricoides, the most common intestinal helminth in Korea, may enter the pancreaticobiliary ducts and cause pancreatitis or cholangitis. However, no case of A. lumbricoides-associated terminal ileitis has been previously reported in Korea. We report a case of a 58-year-old woman who presented with epigastric discomfort and bloating, and was diagnosed with terminal ileitis due to A. lumbricoides detected during colonoscopy.
Anisakis ; Anti-Inflammatory Agents, Non-Steroidal ; Ascaris ; Ascaris lumbricoides ; Cholangitis ; Colonoscopy ; Crohn Disease ; Female ; Helminths ; Humans ; Ileitis ; Inflammatory Bowel Diseases ; Korea ; Middle Aged ; Pancreatitis ; Parasites

One of the most frequent viral infections after kidney transplantation (KT) is cytomegalovirus (CMV) infection. CMV infection causes disease in lung, liver, retina, brain and GI tract and reduce graft survival rate after KT. CMV disease in GI tract is most common in the colon and ileum. CMV enteritis can present with vague abdominal pain, hemorrhage and overt bowel perforation. CMV enteritis in the upper GI tract and colon can be detected early by endoscopy, but it is difficult to diagnose CMV enteritis in the small bowel. We report a rare case with CMV ileitis after KT, who gave up a transplanted kidney at post-operative 3 months in spite of the treatment of CMV infection.
Abdominal Pain ; Brain ; Colon ; Cytomegalovirus* ; Endoscopy ; Enteritis ; Gastrointestinal Tract ; Graft Survival ; Hemorrhage ; Ileitis* ; Ileum ; Kidney Transplantation* ; Kidney* ; Liver ; Lung ; Retina ; Upper Gastrointestinal Tract