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- W2978411754 abstract "Introduction: The incidental finding of terminal ileal (TI) inflammation during routine colonoscopy is not uncommon. TI abnormalities in patients who are undergoing colonoscopy for reasons other than known or suspected inflammatory bowel disease (IBD) have unclear clinical significance. There is limited data on long term followup and outcomes of such findings. We aim to describe the long term follow up of pathology proven incidental terminal ileitis.Figure 1Figure 2Methods: Pathology database was used to identify all adult patients who had terminal ileitis identified in year 2010 and 2011. Follow up was recorded through 05/2015. Electronic medical records were reviewed to exclude patients who had known IBD or clinical suspicion of IBD. Colonoscopy, pathology and imaging data was recorded. Disease progression was defined as unresolving/worsening inflammation and/or persistent symptoms. Means and standard deviations are used to report data. Results: 32 patients met the inclusion criteria. Mean age 53 (SD 15.3) 50% (16/32) were men. This group was followed for a total of 89 person-years with average followup of 3.2 years (range 1 month to 5 years one month). Indications for colonoscopy were screening / surveillance for colon polyps 34% (11/32) abdominal pain 16% (5/32), constipation 9% anemia 9% diarrhea 9% hematochezia 9% and others (bloating, weight loss and diverticulitis). Most common finding on mucosal evaluation was ileal ulceration 53% (17/32) followed by erosions 31%. Other findings included nodularity erythema and cobblestone appearance. 38% (12/32) patients were exposed to NSAIDs before colonoscopy. Cross sectional imaging with contrast was available for 69% (22) patients. 64% (14/22) did not show any small bowel (SB) or colon mucosal abnormality. 6 patients had SB inflammation. 9% (3/32) patients were diagnosed to have Crohn's disease on further followup evaluation with cross sectional imaging and serology. One patient was diagnosed with combined variable immune deficiency, one had repeated episodes of ischemic colitis and one was diagnosed with chronic intestinal pseudo-obstruction. On long term follow up no other cases of disease progression were identified. Conclusion: Terminal ileitis in patients who do not have known or suspected inflammatory bowel disease can be associated with NSAID exposure. It does not progress to IBD commonly. Cross-sectional imaging can be employed to increase level of confidence for ruling out IBD." @default.
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- W2978411754 date "2015-10-01" @default.
- W2978411754 modified "2023-10-16" @default.
- W2978411754 title "Terminal Ileitis of Unknown Significance: Long-Term Follow-up and Outcomes in a Single Cohort of Patients" @default.
- W2978411754 doi "https://doi.org/10.14309/00000434-201510001-01809" @default.
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