{
  "abstract": "Background Terminal ileal ulcers (TIU) are frequently encountered during colonoscopy but are often dismissed as non-specific findings, potentially delaying the diagnosis of Crohn’s disease (CD). This study aimed to evaluate the clinical significance of TIU as an early diagnostic marker and determine the benefits of early intervention.Methods This single-center, retrospective cohort study analyzed consecutive adult patients with TIU detected during colonoscopy over a 10-year period ( IDDF2026-ABS-0301 Figure 1. Flowchart of patient screening and inclusion). Patients were stratified into CD-TIU and non-CD-TIU groups based on follow-up outcomes. We compared clinical, endoscopic, and laboratory features. Treatment responses and long-term surgical outcomes of CD-TIU(CD-L1) were evaluated. Statistical analyses utilized Student’s t-test and chi-square test for group comparisons, with statistical significance defined as P < 0.05.Results Among the 66 patients with TIU, 18 (27.3%) were diagnosed with CD ( IDDF2026-ABS-0301 Table 1). Endoscopic features (IDDF2026-ABS-0301 Table 2, IDDF2026-ABS-0301 Figure 2. Dynamic progression of TIU), including longitudinal or fissuring ulcers (50.0% vs. 6.3%, P<0.001), ileocecal valve deformity (50.0% vs. 18.8%, P=0.011), and larger ulcer size (9.11 mm vs. 4.60 mm, P=0.002), served as robust predictors for CD. Critically, patients diagnosed at the TIU stage (CD-L1) demonstrated a significantly lower surgical rate compared to those with established ileocolonic disease (CD-L3) (5.6% vs. 70.2%, P<0.001) (IDDF2026-ABS-0301 Table 3).Conclusions TIU, particularly those exhibiting longitudinal morphology or ileocecal valve involvement, represent a critical early manifestation of CD. Early identification and intervention at the TIU stage are associated with a significantly reduced risk of surgery, highlighting the necessity of vigilant endoscopic assessment and timely diagnosis.Abstract IDDF2026-ABS-0301 Table 1Baseline and clinical characteristicsCD-TIU Group (18)non CD-TIU Group (48)t/χ2PAge at TIU diagnosis, years40.33±16.86647.90±13.0753.7600.058Endoscopic Follow-up Interval, months41.22±28.81964.06±26.1020.0820.003Sex0.1280.721Male1029Female819Smoking Status0.7380.390Current/Former Smoker310Never Smoker1323Laboratory ParametersWBC (x109/L)7.28±3.486.61±1.53-0.0650.949HGB (g/L)134.39±21.769145.12±18.7660.5530.058PLT (x109/L)291.78±95.903249.76±64.5234.3120.052ALB (g/L)45.328±4.58746.603±3.0667.9850.226Abstract IDDF2026-ABS-0301 Table 2Endoscopic featuresCD-TIU Group (18)nonCD-TIU Group (48)t/χ2PUlcer number0.5200.471Single415Multiple1433Ulver morphology28.169<0.001Round/Oval316Irregular65Longitudinal/fissuring93Punctate024Ulcer Margin0.5180.472Flat1536Elevated312Ulcer Base0.0910.763Clean926Slough922Ulcer Size (mm)9.11±11.084.60±4.54-3.0980.002Peri-ulcer Mucosa0.5370.464Congestion and edema1747Normal11Ileocecal Valve Appearance6.4450.011Normal939Deformed/Ulcerated99Abstract IDDF2026-ABS-0301 Table 3Surgical rateL1 Terminal Ileum (18)L3 Ileocolonic (47)t/χ2P21.811<0.001Surgery133No Surgery1714Abstract IDDF2026-ABS-0301 Figure 1Abstract IDDF2026-ABS-0301 Figure 2",
  "authors": [
    {
      "affiliations": [
        "Beijing Tsinghua Changgung Hospital, China"
      ],
      "name": "Shiming Zhou"
    },
    {
      "affiliations": [
        "Beijing Tsinghua Changgung Hospital, China"
      ],
      "name": "Weiqi Zhang"
    },
    {
      "affiliations": [
        "Beijing Tsinghua Changgung Hospital, China"
      ],
      "name": "Yutang Ren"
    },
    {
      "affiliations": [
        "Beijing Tsinghua Changgung Hospital, China"
      ],
      "name": "Yang Yang"
    }
  ],
  "title": "IDDF2026-ABS-0301 Terminal ileal ulcers as early markers of crohn’s disease: endoscopic predictors and impact on long-term surgical risk",
  "uid": "79e6773e-1e43-564c-97be-7eea15e824d6"
}