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Identification of distinctive clinical significance in hospitalized patients with endoscopic duodenal mucosal lesions

Title
Identification of distinctive clinical significance in hospitalized patients with endoscopic duodenal mucosal lesions
Authors
Han, YejiJung, Hye-KyungChang, Ji YoungMoon, Chang MoKim, Seong-EunShim, Ki-NamJung, Sung-AeKim, Joo-YoungBae, Ji-YunKim, Sae-InLee, Ji-HyunPark, Sanghui
Ewha Authors
정혜경심기남김성은
SCOPUS Author ID
정혜경scopus; 심기남scopus; 김성은scopus
Issue Date
2017
Journal Title
KOREAN JOURNAL OF INTERNAL MEDICINE
ISSN
1226-3303JCR Link2005-6648JCR Link
Citation
vol. 32, no. 5, pp. 827 - 835
Keywords
DuodenitisDuodenal ulcerEndoscopyInflammatory bowel diseases
Publisher
KOREAN ASSOC INTERNAL MEDICINE
Indexed
SCIE; KCI WOS
Abstract
Background/Aims: Duodenitis is not infrequent finding in patient undergoing endoscopy. However, hospitalized patients have a higher incidence of secondary duodenal mucosal lesions that might be related with inflammatory bowel disease (IBD), cytomegalovirus (CMV) infection, tuberculosis, immunologic disorders, or other rare infections. We aimed to identify clinicopathologic features of duodenal mucosal lesions in hospitalized patients. Methods: All hospitalized patients having duodenal mucosal lesions were identified by endoscopic registration data and pathologic data query from 2011 to 2014. The diagnostic index was designed to be sensitive; however, a detailed review of medical record and endoscopic findings was undertaken to improve specificity. Secondary duodenal lesion was defined as having specific reason to explain the duodenal lesion. Results: Among 6,334 hospitalized patients have undergone upper endoscopy, endoscopic duodenal mucosal lesions was detected in 475 patients. Secondary duodenal lesions was 21 patients (4.4%) and the most frequent secondary cause was IBD (n = 7). The mean age of secondary group was significantly lower than that in primary group (42.3 +/- 18.9 years vs. 58.5 +/- 16.8 years, p = 0.00), and nonsteroidal anti-inflammatory drugs were less frequently used in secondary group, but there was no differences of gender or presence of Helicobacter pylori. The involvement of distal part of duodenum including postbulbitis or panduodenitis was more frequently detected in secondary group than in primary group. By multivariate regression analysis, younger age of 29 years and the disease extent were significant predictors for the secondary mucosal lesions. Conclusions: Secondary duodenal mucosal lesions with different pathophysiology, such as IBD or CMV infection, are rare. Disease extent and age seems the most distinctive feature of secondary duodenal mucosal lesions.
DOI
10.3904/kjim.2015.149
Appears in Collections:
의과대학 > 의학과 > Journal papers
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