BACKGROUND The natural history of intestinal lesions in Crohn's disease [CD] is not fully understood. Although the extent of lesions at diagnosis usually defines the extent of the disease, some lesions seen at diagnosis, particularly aphthous ulcers [AUs], may resolve before follow-up. The aim of this study was to evaluate the outcomes of CD patients with colonic AUs seen at diagnosis. METHODS CD patients with aphthous colitis at diagnosis who had been followed since 2001 were included in a case control study matched with two groups of controls: one without colonic involvement at diagnosis and a second group with colonic lesions more severe than AUs at diagnosis. RESULTS Seventy-five patients were included, with a median follow-up of 7.3 years [interquartile range 2.7-9.8]. Seventy-one per cent of those having a second colonoscopy at least 6 months after diagnosis were stable or healed. Medical treatments were similar between the three groups. The AU group's rate of ileal surgery was similar to those without colitis. In multivariate analysis, the independent factors associated with ileal resection were ileal involvement (odds ratio [OR]: 8.8; 95% confidence interval [CI] [7.68-33.75]; p = 0.002) and the presence of severe colitis (OR = 0.5; 95% CI [0.32-0.79], p = 0.003). The risk of ileal surgery was not influenced by the presence of aphthous colitis (OR: 0.63; 95% CI [0.37-1.1]; p = 0.1). CONCLUSION Aphthous colitis at diagnosis seems to resolve in most patients. This suggests that these lesions are of little clinical significance and may not need to be considered prior to ileal resection in CD or when making other important therapeutic decisions.

中文翻译：

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口疮性结肠炎的诊断对克罗恩病结局的影响。

背景技术尚未完全了解克罗恩病[CD]中肠病变的自然史。尽管在诊断时病变的程度通常决定了疾病的程度，但在诊断时见到的某些病变，尤其是口疮[AUs]，可能会在随访之前消退。这项研究的目的是评估在诊断中发现患有结肠AU的CD患者的结局。方法2001年以来一直接受随访的CD确诊为口疮性结肠炎的患者纳入了一项病例对照研究，与两组对照组相匹配：一组在诊断时无结肠受累，另一组在诊断时结肠病变比AUs更严重。结果纳入了75例患者，中位随访时间为7.3年[四分位间距2.7-9.8]。在诊断后至少六个月进行第二次结肠镜检查的患者中有71％稳定或得到了治愈。三组之间的药物治疗相似。AU组的回肠手术率与无结肠炎的相似。在多变量分析中，与回肠切除相关的独立因素是回肠受累（几率[OR]：8.8； 95％置信区间[CI] [7.68-33.75]； p = 0.002）和是否存在严重结肠炎（OR = 0.5）。 ； 95％CI [0.32-0.79]，p = 0.003）。回肠手术的风险不受口疮性结肠炎的影响（OR：0.63； 95％CI [0.37-1.1]； p = 0.1）。结论多数患者在诊断时口疮性结肠炎似乎可以缓解。