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Published on: October 29, 2014
Terminal Ileitis on Imaging Is Rarely Crohn's Disease: A 10-Year Retrospective Cohort Study
Irene Lu1,2, Carl Cosgrave1, Phongsakone Inthavong3
1Department of Gastroenterology Barwon Health Geelong Victoria Australia.
Summary
Computed tomography (CT) detected terminal ileitis is rarely Crohn's disease (CD), with only 12.5% of patients diagnosed. Lower albumin levels predict CD, while standard inflammatory markers are less useful for diagnosing this condition.
Area of Science:
- Gastroenterology
- Radiology
- Internal Medicine
Background:
- Terminal ileitis is a common finding in patients with abdominal pain and altered bowel habits.
- While often linked to Crohn's disease (CD), other causes include infections, surgical conditions, and malignancies.
- Previous research indicates CD accounts for 20%-45% of terminal ileitis cases.
Purpose of the Study:
- To determine the proportion of patients with CT-detected terminal ileitis diagnosed with CD.
- To identify clinical and biochemical predictors of CD in these patients.
Main Methods:
- Retrospective cohort study of adult patients with CT findings of terminal ileitis.
- Data collection included demographics, laboratory values, stool testing, and endoscopic evaluation.
- Multivariable logistic regression analysis was employed to identify CD predictors.
Main Results:
- Out of 128 patients, 16 (12.5%) were diagnosed with CD.
- Infectious (27.7%) and surgical (17.9%) causes were most frequent for non-CD terminal ileitis.
- Lower albumin levels were independently associated with CD (OR 0.82, p=0.004), while routine inflammatory markers showed limited value.
Conclusions:
- A small proportion (12.5%) of CT-detected terminal ileitis cases are attributed to CD.
- Hypoalbuminemia is a significant predictor of CD in this context.
- Further prospective studies are necessary to enhance diagnostic algorithms for CD in patients presenting with terminal ileitis.
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