Diagnostic criteria of inflammatory bowel disease.

摘要

We read with great interest with the case report presented by Shehzad Sheikh et al. [1], but we are confused with the diagnosis of Crohn's disease (CD). How the diagnosis of CD was established after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Maybe it was just the recurrence of the ulcerative colitis (UC). The Pouchoscopy revealed deep ulcerations, stenosis in the pouch and afferent ileum, but the biopsies just revealed the presence of active inflammatory bowel disease (IBD) consisting of UC and CD. Pouch strictures after IPAA are common. Strictures may occur in over 10% of patients with IPAA for UC [2]. The positive perinuclear anti-neutrophil cytoplasmic anti-body (pANCA) just suggests IBD, and it is more prevalent in UC [3]. Herebywe discuss diagnostic criteria of IBD from Western and Asian.Mendeloffs criteria [4], Lennard-Jones criteria [5] are widely used for IBD in Western countries. Mendeloff emphasized that a definite diagnosis of UC should be based on a clinical course of more than six weeks, rule out other disease with a combination of endoscopic, radiological and pathological features. If any one of these was dubious, the diagnosis is regarded as 'probable' only; a definite diagnosis of CD needs typical histopathological findings.