Analysis The Clinical Features Of Smalt Bowel Crohn’s Disease

Objective:To analyze the clinical manifestations and characteristics of Crohn’s Disease (CD)applying Montreal typing standard and further study the clinical characteristics ofsimple Small Bowel Crohn’s Disease (SBCD) through comparing with the colonic andileal CD patients to improve the probability of correct diagnosis and proper treatmentfor SBCD patients in clinical medical treatment.Methods:By retrospectively analyzing the data of patients who were examined anddiagnosed as CD in our hospital during2011-2014,136cases were selected forMontreal clinical typing.60cases were selected from the SBCD patients foranalyzing clinical manifestation and experimental results and summarizing thepathological characteristics manifested during endoscopy and imaging examination.Results:1.typing result for136CD patients based on Montreal typing standardDuring the typing for the selected cases, the patient’s ages were mainly A2type(66.9%), and A3and A1accounted for25.7%and7.4%respectively. From theperspective of the lesion site, the proportion were L4(30.9%), L2(25.7%), L3(23.5%)and L1(19.3%) respectively. From the perspective of the disease behavior, B1(6.3%)accounted for the highest proportion from the total sample, and B2and B3accountedfor24.3%and13.9%respectively, and P type crissum lesion accounted for20.6%.From those28patients with crissum lesion,4cases got Intestinal Stenosis and5casesgot penetrating lesion.2.analysis on the clinical manifestations and characteristics for the60SBCDpatientsFrom the perspective of gender,87%(52) of the60SBCD cases were malewhich has significant different comparing with colonic and ileal CD patients(P＜0.05).From the perspective of age, among the patients who were diagnosed as SBCD for thefirst time,66.9%of them were aged from17to40, and A3type and A1type accounted for25.7%and7.4%respectively, which has no significant differencecomparing with colonic and ileal CD patients（P＞0.05）From the perspective of judgment on disease behavior,20SBCD patients (33.3%)got stenotic lesion, and it accounted for18.8%（6cases）and13.9%(5cases) in ilealCD patients and colonic CD patients respectively. The number of the SBCD cases thatgot stenotic lesion has significant difference comparing with that of colonic and ilealCD patients（P＜0.05）. During the first diagnosis, the number of the colonic and ilealCD patients that got diarrhea have significant difference comparing with that ofSBCD patients (P<0.05). During the first examination, the obstruction symptom hasno significant difference between the three groups (P＞0.05).From the perspective ofsystemic manifestation, the SBCD patients has no significant difference comparingwith the other two groups (P＞0.05). The incident rate of extra intestinal symptom inileal CD patients, colonic CD patients and SBCD patients were28%,36.1%and18.33%respectively, which has no significant difference (P＞0.05). There’re2patients (3.3%) who had2kind of extra intestinal symptom occurred in SBCDpatients, while the number and probability to have two or more kind of extra intestinalin colonic CD and ileal CD patients were7(19.4%) and5(15.6%) cases, from whichwe can see that the number of cases that had extra intestinal symptom in colonic andileal CD patients has significant difference compared with that of small bowel（P＜0.05）.Colonic and Ileal CD patients have more probability to have two or more extraintestinal symptom at the same time compared than small bowel.3.Hemogram of the patients who had CD in different site has no significantdifference (P＞0.05).4.The results of different examination for SBCD patients were different.Endoscope is more suitable for mucosa disease examination, and MRE and CTEare more suitable for examination for intestinal wall and extra intestinal lesion. Thedetection rate of MRE is higher than CTE for intestinal lesion（P＜0.05), and thecontract ability for soft tissue of MRE is higher than CTE（P＜0.05). As for thedetection rate of positive lesion and segmental lesion, the4examination methodsCTE, MRE, enteroscope and Gastrointestinal barium meal have no significant difference. The detection rate of enteroscope is relatively low（P＜0.05), while the it ishigher for detecting Longitudinal ulcer, pebble change nodular hyperplasia and falsepolyp than Gastrointestinal barium meal（P＜0.05).Conclusion:1.Morbidity in male is higher than female in our hospital, and the age of thepatients were mostly A2, and the common site of the lesion were L4, and the B1typeaccounted for highest proportion in disease behavior.2.The SBCD patients has relatively higher probability to have stenotic lesion andrelatively less diarrhea symptom in the first examination as well as less probability tohave two or more extra intestinal symptom.3.Routine laboratory examination has no significant difference on the diagnosisfor CD patients.4.MRE has higher detection rate for extra intestinal lesion and better contractability for soft tissue. Enteroscope has higher detecting rate for Longitudinal ulcer,pebble change nodular hyperplasia and false polyp.