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Clinical Course and Prognosis of Isolated Terminal Ileal Ulcers
Xinjue He1, Yue Chen2, Xinxin Zhou1
1Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Archives of Iranian Medicine
|February 1, 2024
Summary
Isolated terminal ileal ulcers (ITIUs) often resolve on their own. Observational follow-up is a viable strategy for patients with these ulcers, as further investigation or therapy did not significantly alter outcomes.
Area of Science:
- Gastroenterology
- Internal Medicine
- Diagnostic Endoscopy
Background:
- Isolated terminal ileal ulcers (ITIUs) are potential indicators of underlying intestinal conditions.
- Current clinical guidelines for managing ITIUs are lacking.
Purpose of the Study:
- To investigate the diagnostic yield of further small intestine examination in patients with ITIUs.
- To evaluate the prognosis and optimal follow-up strategy for patients with undetermined ITIUs.
Main Methods:
- Retrospective screening of patients undergoing colonoscopy between March 2014 and July 2019.
- Inclusion of patients diagnosed with ITIUs, with some undergoing extended small bowel examination.
- Follow-up of undiagnosed patients for at least one year via telephone to gather prognostic data.
Main Results:
- 120 patients (0.3%) were identified with ITIUs.
- Further small intestine examination in 14 patients yielded limited diagnostic benefit.
- No significant difference in prognosis was observed between empiric therapy and observational follow-up groups over a mean of 35.4 months.
- Most patients showed stable or improved clinical and endoscopic outcomes, irrespective of interventions.
Conclusions:
- Nonspecific isolated terminal ileal ulcers generally exhibit a benign prognosis.
- Observational follow-up emerges as a reasonable and effective management strategy for these patients.
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