RELATIONSHIP BETWEEN ENDOSCOPIC FINDINGS OF THE POUCH AND BOWEL FREQUENCY AFTER RESTORATIVE PROCTOCOLECTOMY IN ULCERATIVE COLITIS

スポンサーリンク

概要

• 論文の詳細を見る

• Background and aim: Pouchitis is one of the late complications of restorative proctocolectomy in ulcerative colitis (UC) and is associated with increased bowel frequency. The present study aimed to clarify the endoscopic findings that are associated with bowel frequency. Patients and methods : The macroscopic and microscopic features in the ileum proximal to the pouch, the pouch, and the remnant short rectum in 100 endoscopies on 63 patients were studied retrospectively. Results : Four of 28 (14%) patients had inflammatory changes in the proximal ileum. Sixty-seven percent of patients showed an abnormal appearance of the pouch. Granularity, friability, presence of mucus, erythema, and erosions were significantly related to bowel frequency. 'Endoscopic pouch activity index' (EPAI), which is the number of positive findings of diffuse erythema, mucus, friability, ulcer, erosion, and granularity, was strongly associated with bowel frequency (P< 0.0001). Patients without macroscopic inflammation in the rectum had significantly lower bowel frequency than those with mild or moderately active inflammation (P0.0294 and 0.0183, respectively). Multivariate analysis revealed that 'endoscopic pouch activity index' and histological grade of pouch inflammation were significant factors (P=0.0004 and P0.0429, respectively) influencing bowel frequency. Time-course study demonstrated that changes in EPAI and macroscopic grade of the rectum were significantly related to alteration in bowel frequency (P=0.0120 and 0.0244, respectively). Conclusion : Erythema, mucus discharge and granularity were significantly related to bowel frequency. EPAI may be useful to evaluate endoscopic pouch inflammation.

• 社団法人 日本消化器内視鏡学会の論文

社団法人 日本消化器内視鏡学会 | 論文

• 経皮内視鏡的胃瘻造設術を受けた患者における生存期間と栄養評価の関係
• 内視鏡的バルーン拡張術にて治療しえたPlummer-Vinson症候群の2例
• 糖尿病に合併した急性壊死性食道炎の1例
• 内視鏡的経鼻膵管ドレナージとオクトレオチドが有効であった膵性胸水の1例
• 重症急性膵炎後膵膿瘍に対し超音波内視鏡ガイド下ドレナージ術が有効であった1例

もっと見る

スポンサーリンク