A COLONOSCOPIC CLASSIFICATION OF APHTHOID LESIONS FOR DIFFERENTIAL DIAGNOSIS OF COLONIC INFLAMMATORY DISEASES

概要

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In 74 patients with aphthoid intestinal lesions who were treated in our hospital during the past 6 years, we investigated the endoscopic morphology of these lesions. There were 37 males and 37 females, with a mean age of 51.4 years. The aphthoid intestinal lesions were endos-copically classified into 3 groups (Groups A : hyperemic, B : aphthoid, and C : verrucous appear-ance or small ulcers). Concerning the distribution, the lesions were mainly located in the rectum to the sigmoid colon in Group A. In Group C, the lesions were most frequently located in the transverse colon or deeper areas. Aphthoid lesions were seen in association with infectious enteritis in 12.2% of the patients, ischemic enteritis in 8.1%, ulcerative colitis (including a tentative diagnosis of ulcerative colitis) in 12.2%, Crohn's disease in 5.4%, and other diseases in 2.7%, whereas the etiology was unclear in 59.4%. Endoscopically, the etiology was unclear in 68.0% in Group A and in 74.2% in Group B. In Group C, infectious enteritis and ischemic enteritis were frequently observed (66.7%). With respect to inflammatory intestinal diseases, 50% of the patients with Crohn's disease were assigned to Group C, whereas all patients with ulcerative colitis were assigned to Groups A or B. In conclusion, this classification can be useful for the differential diagnosis of aphthoid lesions.
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