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Background: Endoscopic mucosal healing is the gold standard for evaluating Crohn's disease (CD) treatment efficacy. Standard endoscopic indices are not routinely used in clinical practice, limiting the quality of retrospective research. A method for retrospectively quantifying mucosal activity from documentation is needed. We evaluated the simplified endoscopic mucosal assessment for CD (SEMA-CD) to determine if it can accurately quantify mucosal severity recorded in colonoscopy reports.
Methods: Pediatric patients with CD underwent colonoscopy that was video recorded and evaluated via Simple Endoscopic Score for CD (SES-CD) and SEMA-CD by central readers. Corresponding colonoscopy reports were de-identified. Central readers blinded to clinical history and video scoring were randomly assigned colonoscopy reports with and without images. The SEMA-CD was scored for each report. Correlation with video SES-CD and SEMA-CD were assessed with Spearman rho, inter-rater, and intrarater reliability with kappa statistics.
Results: Fifty-seven colonoscopy reports were read a total of 347 times. The simplified endoscopic mucosal assessment for CD without images correlated with both SES-CD and SEMA-CD from videos (rho = 0.82, P < .0001 for each). The addition of images provided similar correlation. Inter-rater and intrarater reliability were 0.93 and 0.92, respectively.
Conclusions: The SEMA-CD applied to retrospective evaluation of colonoscopy reports accurately and reproducibly correlates with SES-CD and SEMA-CD of colonoscopy videos. The SEMA-CD for evaluating colonoscopy reports will enable quantifying mucosal healing in retrospective research. Having objective outcome data will enable higher-quality research to be conducted across multicenter collaboratives and in clinical registries. External validation is needed.
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http://dx.doi.org/10.1093/ibd/izab315 | DOI Listing |
Intern Med J
December 2024
Internal Medicine Services, The Prince Charles Hospital, Brisbane, Queensland, Australia.
Background: Iron deficiency anaemia (IDA) related to occult gastrointestinal tract (GIT) blood loss is associated with high rates of GIT malignancies. Major society guidelines recommend bidirectional endoscopic evaluation for all men and post-menopausal women with newly diagnosed, unexplained IDA. However, in patients prescribed direct oral anticoagulants (DOACs), the endoscopic yield, specifically the rate of high-risk findings, including colorectal cancers (CRCs) and advanced adenomas (AAs), is unknown.
View Article and Find Full Text PDFKorean J Gastroenterol
December 2024
Division of Gastroenterology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
A 54-year-old man presented with constipation with a six-month duration and a 5 kg weight loss over 10 months. He had undergone a subtotal gastrectomy and chemotherapy for advanced gastric cancer 13 years earlier. A colonoscopy revealed a firm, circular, in-growing mass in the rectum.
View Article and Find Full Text PDFJ Inflamm Res
December 2024
Department of Colorectal Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310016, People's Republic of China.
Herein, we described a case of small bowel Crohn's disease with recurrent, unexplained fevers, pain in the right lower back, hip, and groin area over 20 months. The patient did not present any gastrointestinal symptoms and colonoscopy showed no abnormalities. Imaging revealed a liver abscess and multiple lesions with pneumatosis in the muscles of the right lower back region.
View Article and Find Full Text PDFSAGE Open Med Case Rep
December 2024
Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Cutaneous metastases from colorectal cancer are an uncommon but critical finding, typically signaling advanced disease with poor prognosis. This case report describes a 64-year-old woman with a limited past medical history who presented to our outpatient dermatology practice with rapidly spreading erythematous, indurated, and nearly verruciform plaques in the groin, vaginal, and perineal region. Biopsy confirmed metastatic adenocarcinoma of colonic origin, and diagnostic imaging, and colonoscopy revealed stage IV colorectal cancer involving extensive cutaneous, lymphatic, and visceral metastases.
View Article and Find Full Text PDFCureus
November 2024
Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Prosthetic joint infection (PJI), caused by Streptococcus bovis group (SBG), is uncommon and related to colorectal cancer. We present here a case of an 84-year-old male who had a past medical history of chronic obstructive pulmonary disease (COPD), congestive heart failure, pulmonary arterial hypertension, iron deficiency anemia, chronic kidney disease, diabetes mellitus, gout, hypertension, bilateral knee replacement with left knee pain and swelling. We initially suspected gout and treated him with prednisolone, but it did not relieve him.
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