Zittan et al reported the Toronto IBD Global Endoscopic Reporting (TIGER) Score for reporting the changes seen on endoscopy of a patient with Crohn's Disease or Ulcerative Colitis. The authors are from Emek Medical Center (Israel), Mount Sinai Hospital, University of Toronto, Technion-Israel Institute of Technology, and the University of Haifa.
Patient selection: inflammatory bowel disease (Crohn's disease or ulcerative colitis)
Segments:
(1) terminal ileum (and cecum)
(2) ascending colon
(3) transverse colon
(4) descending colon
(5) rectum
Parameters:
(1) general mucosal appearance
(2) ulcer/erosion size
(3) narrowing or stricture
(4) percent of surface area showing ulcer or erosion
(5) involvement of segment
Parameter
Finding
Points
general mucosal appearance
normal
0
decreased vascular pattern, erythema
1
absent vascular pattern; marked erythema
2
hemorrhagic mucosa
3
ulcer or erosion size
none
0
erosions < 0.5 cm
1
0.5 to 2 cm (large)
2
> 2 cm (very large)
3
narrowing or stricture
none
0
single, can be passed
1
multiple, can be passed
2
cannot be passed
3
percent of surface area ulcerated
0%
0
< 10%
1
10 to 30%
2
> 30%
3
involvement of segment
non-continuous OR < 50% affected
0
continuous AND >= 50% affected
1
subscore for each segment =
= SUM(points for all of the endoscopic features)
If the subscore is >= 5, then an additional 100 points is assigned.
Interpretation:
• minimum subscore: 0
• maximum subscore: 115
• minimum score: 0
• maximum score: 565 (113 times 5 segments)
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