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A Journal on Internal Medicine

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Frequency: Quarterly

ISSN 0031-0808

Online ISSN 1827-1898


Panminerva Medica 2002 September;44(3):233-6


The uncertain primary diagnosis of inflammatory bowel diseases

Miniello S., Testini M., Piccinni G., Urgesi G., Lissidini G., Tomasicchio N., Centonze A., Bonomo G. M.

Department of Application in Surgery of Innovative Technologies, Section of General and Vascular Surgery and Clinical Oncology, University of Bari, Bari, Italy

Background. The pur­pose of ­this ­study is to re-eval­uate our ­series of ­patients ­affected by a ­colonic non-neo­plastic dis­ease, in ­order to ­measure the per­centage in ­whom we ­were ­unable to ­make a cor­rect diag­nosis ­after the ­first clin­ical and his­to­log­ical ­approach and to ­single-out the rea­sons for our ­inability to ­reach the cor­rect diag­nosis.
Methods. During the ­period 1985-1999 we ­observed 1228 ­patients ­affected by ­chronic inflam­ma­tory ­colonic dis­eases.
Results. In 859 ­patients (69.9%) an ulcer­a­tive col­itis was diag­nosed for the ­first ­time, and 248 ­patients (20.1%) ­were ­affected by Crohn’s col­itis. One hundred and twenty-one ­patients (9.8%) ­were ­defined as ­being ­affected by an unde­ter­mined col­itis. Forty-three ­patients of ­these had a def­i­nite diag­nosis, after­wards: 27 ­patients ­were ­affected by ulcer­a­tive col­itis and 16 by Crohn’s col­itis. Differential diag­nosis ­between inflammatory large bowel diseases (­ILBD) and ­other ­forms of col­itis was set out as fol­lows: 62 ­cases out of 1228 ­were con­se­quent on a bac­te­rial infec­tion or par­a­sit­osis; in 28 ­patients a col­itis pseu­do­mem­bra­nosus was diag­nosed. Eighteen ­cases of ­ischemic col­itis are ­reported and 14 ­patients ­were ­affected by ­NSAID-­related col­itis. In ­another 6 ­patients we diag­nosed a ­postradi­a­tion col­itis. In 22 ­cases mim­icking a Crohn’s col­itis we ascer­tained 9 ­patients ­affected by intes­tinal lym­phoma, 11 myco­bac­te­rium tuber­cu­losis ­related intes­tinal infec­tions and 2 cytom­e­gal­o­virus ­related col­itis.
Conclusions. Despite ­progress in sci­en­tific acqui­si­tions and in diag­nostic ­methods, cor­rect ­initial diag­nosis of ­ILBD is ­still dif­fi­cult, ­even ­though it ­will be ­defined ­with ­time.

language: English


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