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Routine ileoscopy during colonoscopy sometimes identifies ulcers in the prevalvular segment of the terminal ileum or on the ileocecal valve itself in patients without known Crohn's disease. In this study, researchers describe 40 patients with ulcerative ileitis who were identified during 1900 consecutive ileoscopies performed over 5 years by a single colonoscopist in a community practice. Most patients were asymptomatic and undergoing screening colonoscopy.
No patient had a clinical picture suggestive of Crohn's disease. One third of patients had either bright red rectal bleeding or occult bleeding, and 4 patients had iron-deficiency anemia. Ulcers often were found in clusters of 3 to 5, and most were about 5 mm in diameter. Histology reveal…