Aphthoid ulcers in Crohn disease: radiographic course and relationship to bowel appearance.

The relationship of aphthoid ulcers to the appearance of the colon in 14 patients with Crohn disease was determined by retrospective evaluation of radiographs obtained over several years during which various therapeutic regimens had been undertaken. The numbers and locations of the ulcers on the first radiographic examination were recorded and compared with the numbers and sizes on each subsequent examination. The appearance of the bowel area containing aphthoid ulcers was evaluated in comparison with ulcer-free areas. No attempt was made to correlate the course of ulceration with the therapeutic regimen. Results indicate that the fate of aphthoid ulcers is unpredictable. No significant correlation was found between changes in the appearance of the bowel and the numbers and locations of ulcers. Aphthoid ulcers can remain in the colon for years despite worsening or lessening of disease in other bowel segments. In some instances, the bowel segment containing ulcers became frankly diseased; in others, the ulcers disappeared and surrounding tissue appeared normal.