Colonoscopy And Clinical Analysis Of251Cases Of Ileocecal Lesions

Objective：A retrospective analysis of251cases of ileocecal lesions.Summary ofileocecal lesions of various species, distribution, clinical features, pathologicalfeatures.Assessment of colonoscopy and histopathological examination of ileocecallesions diagnosed with ulcerative value.Analysis focused on various types ofendoscopic ulcers features ileocecal.Strengthen the ileocecal understanding of eachdisease.Provide assistance to the clinical diagnosis and treatment of diseases ileocecal.Materials and Methods：The detection of patients in our hospital from December2010to December2013colonoscopy in251cases of ileocecal lesions.All patients underwentcolonoscopy.Companies using PENTAX EC-3870Fk, EC-3890Fi electroniccolonoscopy.All cases were checked to the ileocecal.Were analyzed their sex, age,clinical features, endoscopic diagnosis and pathological examination.Focus on theileocecal ulcerative diseases such as ulcerative colitis, Crohn’s disease, intestinaltuberculosis, malignant lymphoma, colon (ulcerative) diagnosis and differentialdiagnosis.Using SPSS19.0standardized database for statistical analysis.Result:1.In this group,140cases of male,female111cases,ratio of1.26:1.Aged15to84years,the mean age was53years.The clinical manifestations of abdominal pain,diarrhea, blood in the stool, abdominal mass is more common.2.Lesions in the cecum129cases (51.39%),Ileocecal valve33cases(13.15%),Ascending colon beginning of the case34cases (13.55%),Terminal ileum31 cases (12.35%),Appendix opening24cases (9.56%),If lesions involving two or moreparts called multi-site, there are38cases.3.71cases of inflammation of the ileocecal,which pathological mucosal biopsyprompted by56cases of chronic inflammation,15cases did not undergobiopsy;Ileocecal polyps in57cases,inflammatory and hyperplastic polyps43cases,adenomatous polyp14cases;20cases of diverticulitis ileocecal;Ileocecal cancer,35cases,with poorly differentiated adenocarcinoma.9cases of lymphoma,8cases ofdiffuse large B-cell lymphoma,one case of mantle cell lymphoma.19cases of ulcerativecolitis.9cases of Crohn’s disease.Intestinal tuberculosis in2cases,.29cases ofnon-specific ulcer.4.In cases diagnosed,ileocecal ulcer disease including ulcerative colitis (mostlyinvolving the ileocecal full colitis), Crohn’s disease, intestinal tuberculosis, lymphoma,a total of74cases of colorectal cancer.Abdominal pain, diarrhea, in comparisonileocecal ulcer disease is no statistically significant difference in the heat,othersymptoms such as bloody diarrhea, abdominal mass, weight loss in comparisonileocecal ulcer disease, the difference was statistically significant.Among them, thestool is more common in ulcerative colitis, abdominal mass and weight loss in ileocecalcarcinoma and malignant lymphoma is more common.5.Endoscopy and biopsy of great value in the differential diagnosis of ileocecalulcerative lesions.For the ileocecal cancer, high diagnostic value of ulcerative colitis,Crohn’s disease, and but for the differential diagnosis of intestinal tuberculosis was stilldifficult.6.Ulcers of different diseases with different endoscopic features.Ulcerative colitis colonendoscopic diffuse edema, erosion, ulcers, including the ileocecal congestion, erosion,erosion and ulceration of the terminal ileum.Longitudinal fissure-like ulcers as Crohn’sdisease characteristics. Ulcers were more common with single mass formation in theileocecal cancer.There are still a few cases (lymphoma, intestinal tuberculosis, appendiceal mucinous cystadenocarcinoma) endoscopy and biopsy is still not confirmed,and ultimately through the experimental treatment pathological diagnosis.Conclusions: Ileocecal lesions in inflammatory lesions accounted for first place,followed by polyps, third ileocecal cancer, ulcerative colitis, intestinal tuberculosis,Crohn’s disease and lymphoma etc rare.Gender, slightly more men than women, with anaverage age of about50years old.From the onset of the site, the disease occurs in thececum up to close to the ileocecal the beginning of the ascending colon Secondly, theappendix of the most rare.Show nonspecific clinical manifestations ileocecal ulcerativedisease.Most manifestations of abdominal pain, diarrhea, change in bowel habits, bloodin the stool, etc., as well as malignant abdominal mass, weight loss, etc.Endoscopy andendoscopic biopsy for severe ulcerative colitis, colorectal cancer (ulcers) have highdiagnostic value. But for intestinal tuberculosis, the diagnostic value of Crohn’s diseaseand malignant lymphoma is not high, identification more difficult.Due to the limitationsof endoscopic biopsy can only be derived from mucosal biopsies, can not observe thefull thickness of the intestinal wall and the picture of the lesion, but also difficult to findsome of the characteristic lesions. Therefore, the ileocecal ulcerative lesions, althoughthe typical morphological characteristics of different endoscopic ulcers, but a biopsycan not be fully diagnosed, which led to misdiagnosis of the disease.So overall, we needto improve the diagnosis of the cause of ileocecal lesions combined rate based on acomprehensive analysis of the clinical manifestations, endoscopic biopsy of the lesionfeatures.