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Protocol Leads to Ileitis Diagnosis in Most Likely Cases

In cases presenting to emergency department, infection often found to be cause of acute ileitis

FRIDAY, Dec. 11 (HealthDay News) -- A standard protocol for investigating suspected acute ileitis can lead to a definitive diagnosis in the majority of cases, according to research published in the November issue of Clinical Gastroenterology and Hepatology.

Elena Garrido, M.D., of the Ramón y Cajal Hospital in Madrid, Spain, and colleagues analyzed data from patients seen in an emergency department over a two-year period with a presumptive diagnosis of acute ileitis. The three-visit protocol included serum biochemistry, blood counts, imaging with ultrasound or computed tomography, sampling for Salmonella enteritidis and Yersinia enterocolitica, and ileoscopy if needed.

The researchers note that 66 patients were diagnosed with acute ileitis, and a final diagnosis was determined in more than 60 percent of these patients. In most patients, the diagnostic imaging that led to the acute ileitis diagnosis was abdominal ultrasound. The cause was infectious in one-third of the patients, new-onset Crohn's disease in 12.1 percent, and gynecologic conditions in 9.1 percent.

"In conclusion, acute ileitis accounts for 33 of 100,000 consultations in the accident and emergency department of our university hospital. The identification of a cause of acute ileitis after applying a structured diagnostic protocol was reached in more than 60 percent of cases. The main cause identified was bacterial infection. Crohn's disease has to be kept in mind but is responsible only for a minority of cases, usually associated with recurrence and/or the presence of a familial history of inflammatory bowel disease," the authors conclude.

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