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Characteristics and prognosis of isolated small-bowel Crohn’s disease

  • Juan Du
  • Haojie Du
  • Hongtan Chen
  • Lingyan Shen
  • Bingling Zhang
  • Weiwei Xu
  • Zhongchen Zhang
  • Chunxiao ChenEmail author
Original Article
  • 24 Downloads

Abstract

Background

Previous studies suggest that Crohn’s disease (CD) with both small bowel and colon involvement is more serious than colonic CD. However, clinical features of isolated small-bowel CD have not been fully investigated.

Methods

In this retrospective case-control study, 89 patients were divided into two groups according to capsule endoscopy, ileocolonoscopy, and enhanced computed tomography results. The case group was isolated small-bowel CD (n = 50) and the control group was CD with both small bowel and colon involvement (n = 39). We collected data of the patients and analyze it.

Results

In univariate analysis, isolated small-bowel CD group had higher percentage of stricture, Lewis score, platelet, plateletcrit and lower Harvey-Bradshaw index, high-sensitivity C-reactive protein, and erythrocyte sedimentation rate. In multivariable analysis, it had lower Harvey-Bradshaw index (p = 0.000), which meaned relatively mild symptoms. However, it had higher Lewis score (p = 0.007), which meaned more serious small-bowel inflammation. The Kaplan-Meier survival curve also suggested that isolated small-bowel CD patients were more likely to accept partial small intestinal resection surgery (p = 0.029).

Conclusions

Isolated small-bowel CD is easily overlooked for milder clinical symptoms and relatively limited lessions, but severe small-bowel histological injury results in owing worse clinical outcomes. Clinicians should pay more attention to the isolated small-bowel CD and take aggressive intervention during therapy.

Keywords

Inflammatory bowel disease Capsule endoscopy Small bowel Colon 

Notes

Authors’ contributions

CCX, DJ, DHJ, and CHT designed the research; SLY and ZZC collected material and clinical data from patients; DHJ, ZBL, and XWW analyzed data; DJ and DHJ contributed to drafting the manuscript; CCX, CHT, XWW, SLY, and ZBL revised the manuscript; all authors approved the final version of the manuscript.

Funding information

This work was supported by the Major Science and Technology Project of Medical and Health of Zhejiang Province of China, No.WKJ-ZJ-1516.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Juan Du
    • 1
  • Haojie Du
    • 1
  • Hongtan Chen
    • 1
  • Lingyan Shen
    • 2
  • Bingling Zhang
    • 1
  • Weiwei Xu
    • 3
  • Zhongchen Zhang
    • 4
  • Chunxiao Chen
    • 1
    Email author
  1. 1.Department of GastroenterologyZhejiang University School of Medicine First Affiliated HospitalHangzhouChina
  2. 2.Department of GastroenterologyTaizhou Hospital of Zhejiang ProvinceTaizhouChina
  3. 3.Department of EndocrinologyZhejiang University School of Medicine First Affiliated HospitalZhejiangChina
  4. 4.Department of GastroenterologyWenling First People’s HospitalWenlingChina

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