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

Dongshuai Su1,2,3, Rongrong Cao1, Jie Han1

  • 1Department of Gastroenterology, General Hospital of Northern Theater Command, 110840 Shenyang, Liaoning, China.

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|January 29, 2026
PubMed
Summary

Isolated terminal ileal ulcers (ITIU) are increasingly detected during colonoscopy. Younger individuals (age ≤50) show a higher probability of ITIU, and empiric therapy may not be necessary for nonspecific cases.

Keywords:
Crohn diseaseagebody mass indexileal diseasesinflammatory bowel disease

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Internal Medicine

Background:

  • The incidence of isolated terminal ileal ulcers (ITIU) detected during colonoscopy is rising.
  • The clinical significance and risk factors for ITIU remain largely undetermined.

Purpose of the Study:

  • To determine the detection rate of ITIU during colonoscopy.
  • To identify independent risk factors associated with ITIU.
  • To evaluate the outcomes of patients with nonspecific ITIU, with and without empiric therapy.

Main Methods:

  • Retrospective analysis of 11,504 individuals undergoing colonoscopy.
  • Calculation of ITIU detection rate in patients with terminal ileum intubation.
  • Logistic regression analysis to identify risk factors for ITIU.
  • One-year follow-up of patients with nonspecific ITIU.

Main Results:

  • The ITIU detection rate was 1.3% (123/9649) among individuals who completed terminal ileum intubation.
  • Younger age (≤50 years) was independently associated with a higher risk of ITIU (aOR = 1.947, p = 0.033).
  • No significant difference in outcomes was observed between patients with nonspecific ITIU who received empiric therapy versus observation.

Conclusions:

  • Isolated terminal ileal ulcers are not uncommon during colonoscopy.
  • Younger individuals appear to have a greater predisposition to developing ITIU.
  • Empiric therapy is likely unnecessary for patients diagnosed with nonspecific ITIU.