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首页> 外文期刊>Digestive diseases >Diagnostic Yield of Colonoscopy in Young Adults with Lower Gastrointestinal Symptoms in a Multicenter Midwest Cohort
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Diagnostic Yield of Colonoscopy in Young Adults with Lower Gastrointestinal Symptoms in a Multicenter Midwest Cohort

机译：多中心中西部群落中胃肠道症状较低成年人结肠镜检查的诊断产量

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Background/Aims: Serious gastrointestinal (GI) pathologies?are common in older adults compared to young adults (≤40 years). Data on the diagnostic yield (DY) of colonoscopy in young adults with lower GI symptoms are lacking. We aimed to evaluate the overall DY of colonoscopy; and the DY stratified by the presence or absence of bright red blood per rectum (BRBPR) in young adults ≤40 years. Methods: We reviewed diagnostic colonoscopies performed in young adults by 18 gastroenterologists at 2 different institutions from -October 2016 to April 2019. Patients with familial colorectal cancer (CRC) syndromes were excluded. DY was calculated based on the proportion of abnormal colonoscopy defined as having inflammatory bowel disease (IBD), microscopic colitis (MC), advanced adenoma, or CRC. Results: We included 454 patients, mean (SD) age was 31 (3) years, 162 (36%) were males and mean (SD) BMI was 30 (8.5). BRBPR was the indication for colonoscopy in 194 (43%) patients, 260 (57%) patients had colonoscopy for other lower GI symptoms (abdominal pain, chronic diarrhea, constipation) but without BRBPR. Overall DY of colonoscopy in young adults with lower GI symptoms was 15%; IBD was seen in 43 (10%) patients, MC 10 (2%), and advanced neoplasia/CRC 20 (4%). Overall DY in patients with BRBPR was significantly higher than in patients without BRBPR (22 vs. 11%, p = 0.001). The DY for IBD was also higher in young adults with BRBPR versus without BRBPR (15 vs. 6%, p = 0.003). The DY of patients with both BRBPR and abdominal pain was 34%, for BRBPR and diarrhea was 40%, and for all 3 symptoms of BRBPR, diarrhea, and abdominal pain was 52%. Conclusions: Significant proportion of young adults with BRBPR have abnormal pathology (22%) justifying evaluation by colonoscopy. For other lower GI symptoms without BRBPR, the necessity of endoscopic evaluation should be determined clinically on a case-to-case basis due to the low overall DY.
机译：背景/目的：严重胃肠道（GI）疾病？与年轻人相比，在老年人中更常见(≤40年）。缺乏关于患有下消化道症状的年轻成年人结肠镜检查的诊断率（DY）的数据。我们的目的是评估结肠镜检查的整体效果；根据年轻人是否有直肠鲜红色血液（BRBPR）对DY进行分层≤40年。方法：我们回顾了2016年10月至2019年4月，18名肠胃科医生在两个不同机构对年轻人进行的诊断性结肠镜检查。排除有家族性结直肠癌（CRC）综合征的患者。DY是根据定义为炎症性肠病（IBD）、显微镜下结肠炎（MC）、晚期腺瘤或大肠癌的异常结肠镜检查的比例计算的。结果：我们纳入了454例患者，平均（SD）年龄为31（3）岁，162（36%）为男性，平均（SD）BMI为30（8.5）。在194名（43%）患者中，BRBPR是结肠镜检查的指征，260名（57%）患者因其他下消化道症状（腹痛、慢性腹泻、便秘）接受了结肠镜检查，但没有BRBPR。有下消化道症状的年轻人结肠镜检查的总DY为15%；IBD见于43例（10%），MC 10例（2%），晚期肿瘤/大肠癌20例（4%）。BRBPR患者的总体DY显著高于无BRBPR患者（22对11%，p=0.001）。患有BRBPR的年轻人与未患有BRBPR的年轻人相比，IBD的DY也更高（15比6%，p=0.003）。BRBPR合并腹痛患者的DY为34%，BRBPR合并腹泻患者的DY为40%，BRBPR合并腹泻和腹痛患者的DY为52%。结论：BRBPR患者中有相当比例的年轻人有异常病理（22%）可以通过结肠镜进行评估。对于其他无BRBPR的下消化道症状，由于总体DY较低，应根据病例临床确定内镜评估的必要性。

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