Suspected acute ileitis (AI) is a poorly defined clinical condition with multiple causes; its diagnostic protocol has not been standardized properly. We performed a prospective evaluation of the incidence and causes of AI to create a standard protocol for diagnosis.
Methods
The definition of AI included abdominal pain, diarrhea, fever, and at least 1 confirmatory imaging method (abdominal computed tomography scan or ultrasound) showing pathologic changes in the terminal ileum that indicated ileal inflammation. We studied all patients with a presumptive diagnosis of AI seen in the Emergency Room at the Ramón y Cajal Hospital in Madrid, from March 2005 to May 2007, according to a pre-established protocol. Sixty-six patients with primary AI were followed up for at least 6 months.
Results
An infectious cause was found in 33.3% of cases; the most frequently detected microorganism was Yersinia spp. A gynecologic condition was identified in 9.1% of cases initially diagnosed as AI, representing 13.95% of the cases among female patients. Crohn's disease was identified in 12.1% of patients. The diagnostic protocol led to negative results in 33.4% of the patients; 6.1% of patients did not complete the study. The initial diagnosis did not change among any of the patients during the follow-up period.
Conclusions
This protocol led to a definitive diagnosis of AI in more than 60% of potential cases. The most common cause was acute infection. About 10% of cases were of gynecologic origin and about 12% of patients presented with Crohn's disease.
⁎IBD Clinic, Ramón y Cajal Hospital, Madrid, Spain
§Gastroenterology Department, Ramón y Cajal Hospital, Madrid
‡IBDNet, Centro de Investigacin Biomedica en Red de Epidemiologa y Salud Publica (CIBERESP), Madrid, Spain
∥Clinical Biostatistics Unit, Centro de Investigacin Biomedica en Red de Epidemiologa y Salud Publica (CIBERESP), Madrid, Spain
Reprint requests Address requests for reprints to: Dr Elena Garrido, MD, Gastroenterology Department, Hospital Ramon y Cajal, Cra Colmenar K9.100, E28034 Madrid, Spain. fax: (34) 913368771
Conflicts of interest The authors disclose no conflicts.
ABSTRACT