Detection Rate, Risk Factors, and Outcomes of Isolated Terminal Ileal Ulcers

The detection rate of isolated terminal ileal ulcers (ITIU) is increasing during colonoscopy. However, its clinical significance remains unknown. This study aimed to explore the detection rate and risk factors of ITIU in individuals undergoing colonoscopy and evaluate the outcomes of patients with nonspecific ITIU.

Overall, 11,504 consecutive individuals who underwent colonoscopy at Department of Gastroenterology, General Hospital of Northern Theater Command between 1 July 2021 and 31 December 2022 were retrospectively screened. Among the individuals who completed terminal ileum (TI) intubation, the detection rate of ITIU was calculated. Furthermore, among the individuals with complete baseline data, logistic regression analyses were performed to identify the independent factors associated with ITIU. At least one-year follow-up outcome after the index colonoscopy was evaluated in patients with nonspecific ITIU who received and did not receive empiric therapy.

Overall, 9649 individuals completed TI intubation with an ITIU detection rate of 1.3% (123/9649). Among them, 1709 individuals had complete baseline data and were further selected in the risk factor analysis. Compared with the non-ITIU group, the ITIU group was significantly younger (56 vs. 46, p = 0.010). Multivariate logistic regression analyses also demonstrated that age ≤50 years (adjusted odds ratio [aOR] = 1.947, 95% confidence interval [CI] = 1.056-3.587, p = 0.033) was independently associated with ITIU. There was no significant difference in clinical symptoms (p = 1.000) or colonoscopic findings (p = 0.560) between patients with nonspecific ITIU who received empiric therapy and observational follow-up.

ITIU is not rare during colonoscopy. Young individuals may have a higher probability of suffering from ITIU. Empiric therapy may not be necessary for patients with nonspecific ITIU.