期刊
DIGESTIVE AND LIVER DISEASE
卷 53, 期 12, 页码 1548-1558出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.dld.2021.07.037
关键词
Upper gastrointestinal Crohn's disease; Crohn's disease; Epidemiology; Montreal classification
Upper gastrointestinal Crohn's disease (UGI-CD) is a significant subclassification of Crohn's Disease (CD) with a prevalence of 13%. It is most commonly found in the stomach and associated with concurrent ileocolonic involvement. Patients with L4-jejunal disease are more likely to require surgery.
Aims: Upper gastrointestinal Crohn's disease (UGI-CD) is an important subclassification of Crohn's Disease (CD). We performed a systematic review and meta-analysis to evaluate the prevalence, risk factors, and clinical outcomes associated with UGI-CD. Methods: We searched Embase and Medline for articles reporting the clinical information of UGI-CD in CD patients, through 27 October 2020. Disease location and phenotype were coded according to the Montreal classification, and results were pooled with random effects by DerSimonian and Laird model. Results: 26 articles were included. The prevalence of UGI-CD was 13%. UGI-CD was most commonly found in the stomach (56%) and was associated with concurrent ileocolonic involvement (54%). Non-stricturing, non-penetrating UGI-CD was the most common behavioral phenotype (61%). L4-jejunal disease was associated with the highest rates of surgery. Region of origin did not significantly influence the location and phenotype of UGI-CD. Young, male patients presenting with erythema nodosum, aphthous ulcers and stricturing-phenotype are more likely to have UGI-CD, which in turn is linked to increased risk of hospitalization and surgery. Conclusion: UGI-CD is present in 13% of patients with CD, and patients with L4-jejunal disease are more likely to require surgery. Further studies examining the effect of ethnicity and region on UGI-CD are needed. 0 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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