Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, 1650, Section 4, Taiwan Boulevard, Xitun Dist., Taichung City, 40705, Taiwan.
School of Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
BMC Gastroenterol. 2022 Jun 24;22(1):309. doi: 10.1186/s12876-022-02383-x.
Cecal ulcers are sometimes encountered in asymptomatic individuals. Their clinical outcomes and management recommendations remain uncertain.
Asymptomatic patients who underwent a colonoscopic exam for colon cancer screening were retrospectively reviewed from July 2009 to November 2016. Patients with cecal ulcers were included. Patients who had colorectal symptoms, such as abdominal pain, had nonsteroidal anti-inflammatory drugs or were lost to follow-up were excluded.
A total of 34,036 patients underwent colon cancer screening. Cecal ulcers were found in 35 patients. After exclusion, 24 patients (mean duration, 52 months) received follow-up colonoscopy. In 20 patients, (83.3%), cecal ulcer resolved without intervention, but 4 patients (16.7%) developed clinical significant diseases, including intestinal tuberculosis (n = 2), Crohn's disease (n = 1), and ulcerative colitis (n = 1). Patients who developed clinically significant diseases had a higher percentage of ulcers larger than 1 cm (75% vs. 15%, p = 0.035), terminal ileum involvement (100% vs. 15.4%, p = 0.006) and ulcers with irregular fold (75% vs. 5%, p = 0.008).
In patients with asymptomatic cecal ulcers, the endoscopic features included larger ulcer size, terminal ileum involvement and ulcers with irregular fold may predict development of clinically significant diseases. If the above-mentioned features are present, even asymptomatic patients should be closely monitored.
盲肠溃疡在无症状个体中偶有发现。其临床结局和管理推荐仍不确定。
回顾性分析 2009 年 7 月至 2016 年 11 月期间因结肠癌筛查而行结肠镜检查的无症状患者。纳入盲肠溃疡患者。排除有结直肠症状（如腹痛）、服用非甾体抗炎药或失访的患者。
共有 34036 例患者行结肠癌筛查，发现盲肠溃疡 35 例。排除后，24 例患者（平均随访时间 52 个月）接受了随访结肠镜检查。在 20 例患者（83.3%）中，盲肠溃疡无需干预即可自行消退，但 4 例患者（16.7%）出现了临床显著疾病，包括肠结核（n=2）、克罗恩病（n=1）和溃疡性结肠炎（n=1）。出现临床显著疾病的患者中，溃疡大于 1cm 的比例（75%比 15%，p=0.035）、末端回肠受累（100%比 15.4%，p=0.006）和溃疡呈不规则皱襞的比例（75%比 5%，p=0.008）均较高。
在无症状盲肠溃疡患者中，内镜特征包括较大的溃疡大小、末端回肠受累和溃疡呈不规则皱襞，可能预示着发生临床显著疾病。如果存在上述特征，即使是无症状患者也应密切监测。
