Rutgeerts et al developed a grading system to describe the endoscopic appearance of the neoterminal ileum following bowel resection for Crohn's disease. The authors are from the University of Leuven in Belgium.
Evaluation began during the first year following the surgery.
Parameters:
(1) aphthous ulcers
(2) larger lesions
(3) mucosal between lesions
(4) lesions at the ileocolonic anastomosis
Endoscopic Findings
Grade
normal
i,0
1 to 5 aphthous ulcers with normal mucosa in-between
i,1
> 5 aphthous ulcers with normal mucosa in-between
i,2
larger ulcers with normal mucosa in-between (skip lesions)
i,2
ulcers or nodules or narrowing confined to the ileocolonic anastomosis
i,2
diffuse apthous ulcerations with diffuse inflammation
i,3
diffuse inflammation with large ulcers, nodules and/or areas of narrowing
i,4
Low grade changes were associated with an asymptomatic postoperative course, while high grade changes were associated with symptomatic disease.
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