Endoscopic Versus XXXX extent at Presentation of Paediatric @entity29 .

@entity1 @entity66 @entity4628 @entity31 @entity29 @entity30
BACKGROUND: The Paris classification (PC) of paediatric @entity29 (PIBD) categorises disease extent and therefore impacts on treatment decisions Histological (microscopic) disease extent is not incorporated and endoscopic (macroscopic) findings may underrepresent disease extent when compared to histological findings; this study compares disease extent at presentation. METHODS: Data were obtained of @entity1 below 17 years of age diagnosed with IBD from 2010-13 at University Hospital Southampton. Data are presented as percentage of @entity1 undergoing endoscopy. PC was performed alongside a modified PC by histological disease location. RESULTS: 172 @entity1 were identified (median age at diagnosis 13.5, 115 male); @entity30 ( @entity30 )- 107, @entity31 ( @entity31 )- 50, @entity29 Unclassified (IBDU)- 15; 159 had undergone upper GI endoscopy, 163 had undergone lower GI endoscopy. @entity66 was more extensive at all points for @entity30 , @entity31 and IBDU. @entity30 ; @entity4628 in 49% of @entity1 compared to histological disease in 71.3%. Comparing PC; a 10% increase in L3 disease (ileocolonic), a 24% increase in L3+L4a disease (ileocolonic plus upper gastrointestinal (GI)) and a 27% increase in all upper GI involvement if histological disease extent was used. @entity31 ; the most common disease location was the rectum (endoscopic- 91.5% vs histological- 93.6%) and descending colon (endoscopic- 89.4% vs histological-95.7%). Comparing PC; a 19% increase in @entity66 (pancolitis) if histological disease extent was used. CONCLUSION: This data confirms that histological disease extent is greater than endoscopic disease extent. This should be considered when the PC is used. Further study is needed to elucidate which classification would better predict disease outcome.
