[Frequency of proximal colonic extension of distal ulcerative colitis]

Sami Karoui, Lamia Kallel, Zouhair Dahmani, Jalel Boubaker, Azza Filali
La Tunisie Médicale 2007, 85 (8): 669-72

AIMS: To evaluate the frequency of colonic extension in patients with rectal or rectosigmoidal forms of ulcerative colitis and to look for factors associated with a higher risk of proximal colonic extension.

METHODS: We conduct a retrospective study on cases of ulcerative colitis limited to the rectum and the rectosigmoid followed up at least for 6 months. Colonic extension was defined by apparition of endoscopic features of ulcerative colitis in initially normal segments of the colon.

RESULTS: From 1984 to 2004, 70 patients with distal ulcerative colitis were studied. Initial location was the rectum in 25 cases and the rectosigmoid in 45 cases. After a mean follow-up of 49.4 months, proximal colonic extension was observed in 7 cases (10%), with an actuarial frequency of 12% at 5 years, 20% at 10 years and 20% at 20 years. Patients with colonic extension had a higher number of relapses compared to patients without extension (4.28 +/- 1.36 vs. 1,41 +/- 1.22, p = 0.001). Age, sex-ratio, initial location, maintenance therapy and diagnosis of refractory distal colitis were not associated with a higher risk of colonic extension.

CONCLUSION: Colonic extension in our population occurs during the first years after the diagnosis of distal ulcerative colitis. Patients with more relapses are at increased risk of proximal colonic extension.

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