Endoscopic And Clinicopathological Characteristics Of Chronic Intestinal Granulomatous Disease

Objective： to retrospective analysis of chronic intestinal granulomatous diseasepathological morphology, clinical manifestations and endoscopic features, provide thebasis for clinical diagnosis.Methods： Collect102cases of patients with chronic intestinal granulomatousdisease,who were admitted to Yijishan Hospital of Wannan Medical College,formJanuary2008-December2013,.According to etiology,11patients who were diagnosed asITB (intestinal tuberculosis, ITB),27patients who were diagnosed CD (Crohn ’s diseases,CD),49patients who were diagnosed UC (ulcerative colitis, UC) in49cases,15patientdwho were diagnosed as intestinal schistosomiasis, summarizes each performance inclinical, endoscopic and pathological features.Results:11cases of patients with ITB, the average age of46.1years, and ratio of men andwomen is8:3,,relative occurs in male patients, clinical course is usually3-6months,81.8%of patients with abdominal pain;27.3%of patients with Diarrhea;45.5%ofpatients with Fever; none of patients with bloody stools;18.2%of patients with intestinalobstruction.54.4%of patients with hypoalbuminemia,81.8%of patients with C-reactiveprotein increases,54.5%of patients with blood sedimentation increased,72.7%of patientswith anemia. Colon lesions involving blind back of only45.5%, involving54.5%,54.5% of patients with ulcer,54.5%of patients with nodular hyperplasia,27.3%of patientswith intestinal stenosis.63.6%of patients with lymphocyte gathered;9%of patients withEosinophils; No crack sample ulcer; Caseous granulomatous detected36.4%ofpatients;63.6%of patients with Giant cells.27patients with CD at an average age of45.4years, the youngest was15years, the oldest was74years old, male and female ratio of13/14, the average course of disease of1year,77.8%of patients presented withabdominal pain,14.8%of patients with diarrhea,25.9%of patients with fever,7.4%ofpatients with bloody stools, the incidence of intestinal obstruction is0,3.7%of patientswith bowel perforation,3.7%of patients with perianal disease.51.9%of patients withhypoproteinemia, the lowest20.3g/L;63.0%of patients with C-reactive proteinincreased,63.0%of patients with blood sedimentation increased.88.9%of patients withanemia.48.1%of patients involved lleocecal,7.4%of patients involved lleocon,22.2%of patients involved the small intestine,22.2%of patients involved colon;22.2%ofpatients with ulcer is longitudinal,29.6%of patients with irregular ulcer;14.8%ofpatients with pebbles;29.6%of patients with Intestinal stenosis.37.0%of patients withlongitudinal ulcer; Granulomatous detected18.1%of patients, none of cases is caseousgranulomatous, non caseous granuloma in5cases;5cases detected1granuloma;Granuloma position is located in the lamina propria is3.7%, granuloma position islocated in the submucosa is14.8%;25.9%of patients with Lamina propria lymphocytegathered.49patients with CD at an average age of38.9years on, the youngest is16years old, the oldest is75years old;81.3%patients with abdominal pain,91.8%ofpatients with diarrhea, generally3to5times/day,32.7%of patients with purulent bloodstools,73.5%patients with fever,None of patients occurred ntestinal obstruction andintestinal perforation;28.6%of patients with hypoalbuminemia, the minimum can be to24.6g/L;55.1%of patients with C-reactive protein increased;59.2%of patients withanemia.91.8%of patients lesions involvde the rectum,91.8%of patients involved thecolon,2cases only involved the rectum;40.8%of patients with continuity ulcer;8.2% of patients with nodular hyperplasia;36.7%of patients with brittle;34.7%of patientswas Easy bleeding.15patients with intestinal schistosomiasis at an average age of64.7years, the youngest was47years, the oldest was70years old; Course of6months to6years;66.7%of patients with Abdominal pain,13.3%of patients witn diarrhea; No fevercases;33.3%patients with blood stools;6.7%of patients with Intestinal obstruction.Nobowel perforation cases;13.3%of patients with hypoalbuminemia; C-reactive proteinincreased was13.3%of patients;46.7%of patients with anemia; No eosinophil increased,6.7%of patients involved the appendix,20%of patients involved sigmoid colon;53.3%of patients with ulcer;6.7%of patients with swell polypoid,73.3%of patients withinflammatory cell infiltration,33.3%of patients with eosinophils infiltration.Pathologicalfound that cancer cells by66.7%.Conclusion: chronic intestinal granulomatous disease can diagnosis by the typicalpathological changes such as caseous granulomatous.They have similar clinical,endoscopic and pathological. The analysis ITB occurs in middle-aged and old patients,male, major clinical manifestations of abdominal pain diarrhea, there are many intestinaltuberculosis, ITB occurs lleocecal generally.checking out the caseous granuloma is thegold standard of diagnosis; CD occurs in middle age, clinical manifestation of abdominalpain, also can be characterized by diarrhea, lesions mainly involved lleocecal, ulcer intolongitudinal distribution,which shape is irregular, CD can see pebbles inendoscopy,.Pathological fracture is sample ulcer and non caseous granuloma; UC ageslightly younger than CD and ITB.Clinical manifestations are mainly abdominal pain,diarrhea, and mucus purulent blood stools, Disease occurs in the rectum, sigmoidcolon,.Ulcer is continuity; Intestinal schistosomiasis occurs in the elderly, more commenin men, clinical mainly characterized by abdominal pain, diarrhea, bloody stools, the maininvolvement of rectum and associated with cancer.