Ulcerative colitis (UC) is characterized by continuous mucosal inflammation of the rectum, extending uninterrupted to a variable portion of the colon proximally. However, in some patients with distal colitis, a distinct pattern of skip inflammation (so-called patch) involves the cecum and/or appendiceal orifice, but data on this entity are contradictory, and its significance and prognosis are still debated. We identified 102 adult cases of left-sided UC with a cecal/periappendiceal patch and compared them to 102 controls (left-sided UC only) along clinicopathologic characteristics and disease outcomes. In multivariate analysis, patients with a patch were younger (median age: 31 vs. 41 y; P=0.004) and more likely to have rectosigmoid involvement only (58.8% vs. 28.4%; P<0.001), compared with patients without a patch. During follow-up, patients with a patch were more likely to be eventually diagnosed with Crohn disease (CD) (9.8% vs. 1.0%; P=0.022) and to show proximal extension of inflammation (35.6% vs. 10.0%; P=0.021), but showed no differences in rates of neoplasia, colectomy, or pharmacotherapy escalation. Kaplan-Meier analysis confirmed that patients with a biopsy diagnosis of cecal/periappendiceal patch were more likely to show proximal disease extension (P<0.001) and to be diagnosed with CD (P=0.008). In conclusion, cecal/periappendiceal skip inflammation in left-sided UC occurs more often in younger patients and in those with rectosigmoid involvement and is associated with proximal disease extension and, in a small fraction of cases, change of diagnosis to CD. However, it does not portend increased risk of neoplasia, pharmacotherapy escalation, or subsequent colectomy, compared with patients with left-sided UC only.

溃疡性结肠炎（UC）的特征是直肠的持续粘膜炎症，不间断地延伸至近端结肠的可变部分。然而，在一些远端结肠炎患者中，一种独特的跳跃性炎症（所谓的斑片）涉及盲肠和/或阑尾口，但有关该实体的数据是矛盾的，其意义和预后仍有争议。我们确定了 102 例带有盲肠/阑尾周围补片的左侧 UC 成人病例，并将其与 102 例对照（仅左侧 UC）的临床病理特征和疾病结果进行了比较。在多变量分析中，与没有贴片的患者相比，贴有贴片的患者更年轻（中位年龄：31 岁 vs. 41 岁；P = 0.004），并且更有可能仅累及直肠乙状结肠（58.8% vs. 28.4%；P <0.001）。修补。在随访过程中，贴有补片的患者最终更有可能被诊断为克罗恩病 (CD)（9.8% vs. 1.0%；P = 0.022），并显示出近端炎症扩展（35.6% vs. 10.0%；P =0.021），但肿瘤、结肠切除术或药物治疗升级的发生率没有差异。Kaplan-Meier 分析证实，活检诊断为盲肠/阑尾周围补片的患者更有可能出现近端疾病扩展 ( P <0.001) 并被诊断为 CD ( P = 0.008)。总之，左侧 UC 的盲肠/阑尾周围跳跃性炎症更常发生在年轻患者和直肠乙状结肠受累的患者中，并且与近端疾病扩展相关，在一小部分病例中，与 CD 的诊断改变有关。然而，与仅患有左侧UC的患者相比，这并不预示着肿瘤形成、药物治疗升级或随后的结肠切除术的风险增加。