Comparison of the extent of pediatric inflammatory bowel disease based on endo-colonoscopy and histological findings

Abstract

Introduction: Paris classification for the extent of inflammatory bowel disease (IBD) in children is based solely on macroscopic findings obtained via endo-colonoscopy. However, in some cases histologic findings may indicate more severe cases. Objectives: The aim of the present study was to compare the extent of pediatric IBD based on endo-colonoscopy and pathological findings. Methods: Data on 67 hospitalizations were collected from 51 children with IBD who had been admitted to the children’s medical center of Tehran. All subjects underwent endoscopy or colonoscopy and had a histological report. Results: Comparison of the endoscopic and histological findings in ulcerative colitis showed that, in 37% of cases, gastric involvement was reported in histology, while these cases were reported normal in endoscopy. In colonoscopy, the transverse colon was more involved, as compared with the results of histology, while in other parts of the colon, the histological involvement showed more severe findings. Considering Paris classification, in 25% of cases, the extent of the disease was higher in colonoscopy, and in 16% of cases, it was higher in histology. Of all children with Crohn’s disease, gastric involvement in 20% of cases and esophageal and duodenal involvement in 13% of cases were more reported in histology than in endoscopy. In the ascending colon, descending colon, and rectosigmoid, histological involvement was more than that observed in colonoscopy. Considering Paris classification, in 5% of cases, the extent of the disease was higher in colonoscopy, and in 9% of cases, it was higher in histology. Conclusion: Concurrent use of histological findings and endoscopic findings may help to better determine the severity and extent of the disease and facilitate the process of treatment.