.228 Cases Of Ileocecal Ulcer Were Retrospectively Analyzed

Objective:Retrospective analysis of the clinical datas of the 228 patients with ileocecal ulcer, and disscuss the differential diagnosis value of endoscopic and pathological examination to 228 cases of ileocecal ulcer.Methods:Colleted 228 cases of ileocecal ulcer in colonoscopy examination in our hospital from 2006 to 2010, Summarized and analyzed their clinical, endoscopic and pathological features, treatment and follow-up, and compared the endoscopic morphology of Crohn's disease and intestinal tuberculosis.Results:Abdominal pain, diarrhea, pus and blood stool/bloody stool is more common in the clinical manifestations of the 228 patients with ileocecal ulcer. There were 44 cases of ulcerative colitis (19.30%), multiple ulcers with diffuse involvement of the entire colon and continuous mucous membrane lesions were more common in ulcerative colitis, and their symptoms relived when they were treated by Ai Disha and hormone,11 patients received colonoscopic check again and their colonoscopic performance improved obviously; There were 30 cases of Crohn's disease (13.16%), longitudinal or irregular ulcers and cobblestone appearance were significantly more common in patients with Crohn's disease, four patients were diagnosed by colonoscopy and histopathology, three patients by operation and histopathology,23 patients were followed up after treatment and confirmed, and 15 patients revieved colonoscopic check again and their colonoscopic performance improved after treatment; There were 15 cases of intestinal tuberculosis (6.58%), transverse ulcers and pseudopolyps were observed more frequently in patients with intestinal tuberculosis, two patients were diagnosed by colonoscopy and histopathology, when one patient by operation and histopathology,12 patients supported the diagnosis after anti-tuberculosis treatment; There were 27 cases of ileocecal cancer (11.84%), the cases of single ulceration accompanied by tumors were mostly ileocecal cancer; There were 5 cases of lymphoma (2.19%), erosions and ulcers were scattered in the entire colon or ileocecal mucosa; There were 3 cases of rheumatoid related diseases (1.32%), including one patient with Behcet's disease and 2 patients with connective tissue disease; There were 87 cases of infectious colitis (36.16%), which showed neat or limited ulcers, most patients relived after treatment,7 patients received colonoscopic check again and found erosion and ulceration disappeared; 17 patients were undiagnosed (7.45%), they didn't have specific endoscopic and pathological features, and were lost.Conclusion:1. The patients with ulcerative colitis or ileocecal tumor were usually diagnosed by colonoscopy and histopathology. The patients with infectious colitis relived after treatment, and their ileocecal ulcers were neat or limited; Most of the patients with Crohn's disease or intestinal tuberculosis were followed up after test treatment and diagnosed, when a few of them were diagnosed by colonoscopy and histopathology.2. Longitudinal or irregular ulcers, cobblestone appearance and strictures were more common in patients with Crohn's disease, when transverse ulcers and pseudopolyps were more frequently observed in patients with intestinal tuberculosis. 3. The diagnosis of ileocecal ulcer lesions rely mainly on histopathology and test treatment, especially intestinal tuberculosis and Crohn's disease; it is necessary to find a specific serum or immunohistochemical indicator to differential diagnosis of ileocecal ulcer.