Some Problems in New Criteria of Crohn's Disease Tatsuo Oriuchi 1 , Nobuo Hiwatashi 1 , Seiichi Takahashi 1 1Department of Gastroenterology, Tohoku University School of Medicine Keyword: Crohn病 , 肛門部病変 , 診断基準 , indeterminate colitis pp.135-147
Published Date 2001/2/25
DOI https://doi.org/10.11477/mf.1403103104
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 To clarify the problem of Japanese diagnostic criteria for Crohn's disease (1995), we examined the clinical data of 10 patients with CD who could not be definitely diagnosed during their first visit to hospital. In three patients, small bowel enema had not been carried out, because CD was not suspected clinically. Four patients had undergone insufficient examination of the area from the small intestine to the proximal colon, as we didn't doubt the diagnosis of ulcerative colitis that had been made in the previous hospital. Three patients had multiple intestinal aphthas and small ulcers with perianal lesions or fever. However, as epithelioid cell granulomas had not been detected in their biopsied specimens, they could not be definitely diagnosed as having CD. Perianal lesions, for example, intractable periproctal fistulas, are highly complicated, and this type of lesion is one of the most characteristic lesions of CD and often occurs at the onset. Because of this, we think that perianal lesions may be restored to the Japanese diagnostic criteria of CD. The addition of perianal lesion would certainly contribute to diagnosis of CD, especially in early stage CD.

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