Pathologic Features and Clinical Significance of “Backwash” Ileitis in Ulcerative Colitis

@article{Haskell2005PathologicFA,
  title={Pathologic Features and Clinical Significance of “Backwash” Ileitis in Ulcerative Colitis},
  author={Henry L. Haskell and Charles W. Andrews and Sarathchandra I. Reddy and Kleanthis G. Dendrinos and Francis A. Farraye and Arthur F. Stucchi and James M. Becker and Robert D Odze},
  journal={The American Journal of Surgical Pathology},
  year={2005},
  volume={29},
  pages={1472-1481}
}
Patients with ulcerative colitis (UC) may develop inflammation in the distal ileum thought to be due to “backwash” of cecal contents (“backwash ileitis”). However, a systematic analysis of ileal changes in UC has never been performed, and the prevalence and criteria for “backwash” ileitis have not been defined. The aim of this study was to evaluate the prevalence and spectrum of inflammatory changes in the ileum in patients with UC and to correlate ileal changes with outcome after total… 
Microscopic / "Backwash" Ileitis and its Association with Colonic Disease in New Onset Pediatric Ulcerative Colitis.
TLDR
Patients with new onset ulcerative colitis may have microscopic ileal inflammation at time of diagnosis, even if the terminal ileum appears macroscopically normal, and children with microscopic ilesitis in the context of UC do not need to be reclassified as "indeterminate colitis" or Crohn's disease.
Contemporary morphologic definition of backwash ileitis in ulcerative colitis and features that distinguish it from Crohn disease.
TLDR
Terminal ileum (TI) sections from 250 ulcerative colitis (UC) total colectomy specimens resected during 3 periods and endoscopic TI biopsy specimens from 100 contemporary chronic UC and 100 Crohn disease patients were reviewed, finding the activity level of BWI correlated with level of cecal UC.
Mucosal inflammation in the terminal ileum of ulcerative colitis patients: endoscopic findings and cytokine profiles.
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Pathologic Features of Ulcerative Colitis in Patients With Primary Sclerosing Cholangitis: A Case-control Study
TLDR
UC patients with PSC show a propensity for more extensive, but less active, disease but are otherwise characterized by similar pathologic findings compared with UC patients without PSC.
Backwash Is Hogwash: The Clinical Significance of Ileitis in Ulcerative Colitis
TLDR
Evidence is cited to propose that ileal infl ammation in UC may simply represent a primary manifestation of UC in that organ, for which the term “UC-associated ileitis” is proposed.
Ileal Perforation in a Patient with Ulcerative Colitis after Proctocolectomy
TLDR
A 66-year-old male with UC who presented with ileal perforation eight days after proctocolectomy is reported, indicating that backwash ileitis or diffuse enteritis is the most probable diagnosis in this case.
Prospective Evaluation of Terminal Ileitis in a Surveillance Population of Patients with Ulcerative Colitis
TLDR
Ileitis in Patients with UC may represent a primary extracolonic manifestation of UC in patients with inactive or mild disease and is not due to backwash.
Discrete terminal ileal ulcers in patients diagnosed with ulcerative colitis: clinical significance and natural course
TLDR
Discrete TI ulcers are more common in patients with UC, compared with the healthy cohort, and no significant clinical impact on disease extension and severity is found.
Ileal lesions in patients with ulcerative colitis after ileo-rectal anastomosis: relationship with colonic metaplasia.
TLDR
Findings suggest that in UC, ileal lesions associated with changes towards colonic epithelium may develop also after IRA, which may contribute to the development of colonic metaplasia.
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