Clinical Analysis Of 333 Cases Of Ulcer Disease In Ileocecal Region

Objective: Ileocecal ulceration is more common clinically,and often result in misdiagnosis or delayed diagnosis and treatment due to the variety of diseases and difficulty in distinguishing.The purpose of this study is to analyze the clinical characteristics of ileocecal ulceration,and to provide help for the diagnosis and differential diagnosis of these diseases.Methods: In this study,from January 2012 to December 2019,a total of 333 patients with ileocecal ulceration diagnosed by colonoscopy or imaging examination in the First Affiliated Hospital of Chongqing Medical University were collected,and to statistical analysis of clinical manifestations,imaging features,colonoscopy and biopsy pathology of all patients.Results: A total of 333 cases were collected,diagnosed cases include intestinal tuberculosis(73 cases),Crohn's disease(79 cases),ulcerative colitis(39 cases),nonspecific ulcer(24 cases),ileocecal cancer(16 cases),colon cancer with ileoceccal ulcer(6 cases),lymphoma(19 cases),intestinal Behcet's disease(10 cases),infectious ulcer(4 cases),drug ulcer(6 cases),Ischemic bowel disease(1 case).We compared intestinal tuberculosis,Crohn's disease,and ulcerative colitis and found that patients with intestinaltuberculosis had fever,night sweats,positive T-spot and PPD tests,lung involvement,ring ulcers,lymph node calcification / necrosis / enhanced Specificity.Crohn's disease with abdominal and perianal fistulas,segmental lesions,longitudinal ulcers,intestinal mucosal nodules and paving stones-like changes,involving the submucosa is conducive to diagnosis.Ulcerative colitis is more common with mucous pus and bloody stools,diffuse irregular ulcers,and a wide range of lesions.Crohn's disease and intestinal tuberculosis mostly manifest as terminal ileal ulcers.Malignant ulcers are more common on the basis of mucosal tissue hyperplasia,followed by giant ulcers,and the surrounding mucosa is obviously nodular-like hyperplasia.Older people who have recently taken non-steroidal anti-inflammatory drugs may have drug-induced ulcers.Behcet's disease is mostly a single huge ulcer,about 50% with oral and / or vulvar ulcers.Conclusion: Although it is difficult to make a definite diagnosis of ileocecal ulcer disease,there are special features in symptom characteristics,imaging characteristics,endoscopy and biopsy of different diseases.It is necessary for clinicians to analyze their clinical experience and examination results comprehensively in order to correctly find the key clues to diagnose the disease in the complex manifestations.