Maté-Jimenez J, Correa-Estañ J A, Perez-Miranda M, Gomez-Cedenilla A, Pajares J M, Moreno-Otero R
Hospital de la Princesa, Servicio de Aparato Digestivo, Universidad Autonoma de Madrid, Spain.
Eur J Gastroenterol Hepatol. 1996 Dec;8(12):1185-8. doi: 10.1097/00042737-199612000-00010.
Epidemiological studies have found an increased frequency of childhood infections and tonsillectomies in patients with inflammatory bowel disease (IBD). The aim of our study was to test whether particular clinical patterns of IBD could be associated with previous tonsillectomy.
Two hundred and twenty consecutive IBD patients (100 with Crohn's disease (CD) and 120 with ulcerative colitis (UC)) were prospectively assessed and classified into groups according to disease location. In those with a positive history of tonsillectomy, an ear, nose and throat (ENT) examination was carried out to confirm the diagnosis.
Eighty-two IBD patients (37%) underwent tonsillectomy in childhood: 47 out of 100 CD patients (47%), and 35 out of 120 UC patients (29%). Disease location in CD patients affected the ileum in 28, and 21 of them were tonsillectomized (tonsillectomy rate of 75%). Thirty-six patients had an ileocolonic location, and 14 of them had had a tonsillectomy (39%). With disease confined to the colon, only 9 out of 29 patients (31%) had undergone previous tonsillectomy. The higher prevalence of tonsillectomy in patients with CD ileitis was statistically significant (P = 0.0034). No significant differences between groups of UC patients according to the extent of the disease were found.
The ileum is the most prevalent location of disease in CD patients with previous tonsillectomy.
流行病学研究发现，炎症性肠病（IBD）患者童年感染和扁桃体切除术的发生率增加。我们研究的目的是检验IBD的特定临床模式是否与既往扁桃体切除术有关。
对连续220例IBD患者（100例克罗恩病（CD）患者和120例溃疡性结肠炎（UC）患者）进行前瞻性评估，并根据疾病部位分组。对有扁桃体切除术阳性病史的患者进行耳鼻喉（ENT）检查以确诊。
82例IBD患者（37%）在童年时接受了扁桃体切除术：100例CD患者中有47例（47%），120例UC患者中有35例（29%）。CD患者的疾病部位累及回肠的有28例，其中21例接受了扁桃体切除术（扁桃体切除率为75%）。36例患者病变位于回结肠，其中14例接受过扁桃体切除术（39%）。病变局限于结肠的29例患者中，只有9例（31%）曾接受过扁桃体切除术。CD回肠炎患者扁桃体切除术的较高患病率具有统计学意义（P = 0.0034）。根据疾病程度分组的UC患者组之间未发现显著差异。
在既往有扁桃体切除术的CD患者中，回肠是最常见的疾病部位。
