Isolated Terminal Ileitis: When Is It Not Crohn’s Disease?

Excerpt

We have read with interest the article entitled: “Isolated acute terminal ileitis without preexisting inflammatory bowel disease rarely progresses to Crohn’s disease.” Only 4.6% of 108 patients with acute terminal ileitis (TI) diagnosed at ileocolonoscopy developed Crohn’s disease (CD) [1]. There is paucity in the literature on how best to manage patients with TI and what percentage of these patients eventually develop CD [2]. More specifically, the literature is even more limited when it comes to patients with isolated terminal ileitis (ITI) on small bowel capsule endoscopy (SBCE) [3]. Ideally, patients with TI secondary to CD should be picked up without delay to ensure treatment is initiated early in the course of disease to prevent long-term sequelae. …