The isolated caecal patch lesion: a clinical, endoscopic and histopathological study

Area of Science:

• Gastroenterology
• Pathology
• Endoscopy

Background:

• A previously undescribed endoscopic phenomenon, the isolated caecal patch lesion, presents with features of chronic inflammatory bowel disease (IBD) but lacks concurrent IBD elsewhere.
• Understanding the etiology of these isolated lesions is crucial for accurate diagnosis and patient management.

Purpose of the Study:

• To describe the characteristics of isolated caecal patch lesions.
• To investigate the potential causes and associations of these lesions, particularly in relation to chronic inflammatory bowel disease.

Main Methods:

• Prospective collection of six cases over a 10-year period by a specialist gastrointestinal pathologist.
• Comprehensive endoscopic and histopathological analysis of each case.
• Follow-up investigations to determine the likely cause(s) of the observed lesions.

Main Results:

• Two cases showed a strong association with ulcerative colitis (UC), with one lesion preceding and another occurring after established UC.
• Two lesions in younger patients suggest a potential predictive role for future chronic inflammatory bowel disease.
• Two cases were attributed to the effects of non-steroidal anti-inflammatory drug (NSAID) therapy.

Conclusions:

• Isolated caecal patch lesions can be identified endoscopically and histopathologically.
• While often associated with ulcerative colitis, solitary caecal patch lesions may have diverse etiologies.
• These lesions maintain a significant relationship with chronic inflammatory bowel disease, even when presenting in isolation.