Improve Understanding Of Ileocecal Ulcerative Lesions

Objective:To have an acquaintance with the general incidence of this disease by retrospectively analyzing the ileocecal ulcerative lesions diagnosed by our hospital in the recent three years; To compare spectrum of disease and the distribution of constituent ratios, gender and ages; To evaluate the value and the diagnose accordance rate by colonoscopy and endoscopic biopsy with regard to ileocecal ulcerative lesions; To analyze the characteristics of various types of ulcers under colonoscope and enhance the understanding of this kind of diagnoses and the differential diagnoses.Methods:Firstly, we retrospectively investigated the 79 cases of ileocecal ulcerative lesions which were done by the detection of the check under colonoscopy and then the definite diagnoses under the colonoscopy and biopsy or postopreative pathology. Secondly, we listed out the gender, ages, endoscopic features, initial diagnoses, endoscopic diagnoses or postoperative pathological diagnoses, the condition of patients hospitalized, the discharge diagnoses and so forth. The last step was comparatively analyzing the results.Results:The 79 cases of ulcerative lesions including apophysis ulcers accounted for 34.05% of ileocecal lesions with the malignants occupying a larger proportion, that was,64.56%. According to the record, the age distribution of this disease mainly focused on the age between 30 and 40 and the age between 50 and 80. Nevertheless, there was no distinct difference between the male group and the female group in the age distribution. On the contrary, considering the disease constitution, the occurrence of colon cancer and ulcerative colitis was common. Besides, the initially exact diagnoses under endoscopy were 49 cases, accounting for 62.03%, most of which were diagnosed as colon cancer and ulcerative colitis. However, the exact diagnoses by endoscopic biopsy were a little less than endoscopy. They amounted to 47 cases, accounting for 59.49% with a majority diagnosed as colon cancer, ulcerative colitis and non-characteristic inflammation of the colon. It could also be drawn from the record that the most exact diagnoses were done by way of combining endoscopy with endoscopic biopsy, the number of which was 70, accounting for totally 88.61%. Obviously, its rate of exact diagnoses was higher than those of endoscopy and endoscopic biopsy. Apart from the comparison of the three kinds of check, there was another result. Different diseases had different characteristics under endoscopy. For instance, the single mass with ulcer appeared more frequently in colon cancer. In addition, the case of spreading ulceration in the overall colon or colon in the right side obserned as the continuous mucosa lesion usually was ulcerative colitis. And the longitudinal ulcer was the feature of crohn's disease. But there were still 9 cases including 4 cases of intestinal tuberculosis,2 cases of malignant lymphoma,1 case of colon cancer,1 case of eosinophilic granulomatous enteritis and 1 case of allergic enteropathy,which could not be diagnosed directly by the endoscopy and endoscopic biopsy. Therefore, nothing else could be done on the patients but let the partients receive operation or send them to the reexamination of endoscopy after experimental treatment.Conclusions:(1) The ileocecal ulcerative lesions were common in endoscopy, most of which were malignant lesions. And there was no conspicuous difference in ages and gender in light of their occurrence. (2) Simple electronic colonoscopy and simple endoscopic biopsy were not enough for the diagnoses of this disease whereas the combination of them could greatly enhance the rate of exact diagnoses. (3) The different characteristics of different kinds of leocecal Ulcerative lesions contributed to the identification of the diagnosing process. (4) Difficulty remained in the diagnoses of a minority of ucerative lesions. Hence, clinical history or surgical exploration should be combined with the diagnoses.