Computed tomography vs barium studies in the acutely symptomatic patient with Crohn disease.
Gastrointestinal contrast studies and CT performed on 43 patients with known Crohn disease with acute symptoms were retrospectively reviewed to assess the ability of each study to define the location and extent of disease. In 39 of 43 (91%) patients the contrast studies and CT agreed on the location of active disease. However, in 15 of 43 (35%) patients, contrast studies demonstrated additional areas of mucosal disease remote from the major area of activity that were not suggested by CT. In addition to demonstrating more extensive mucosal disease, contrast studies proved superior in demonstrating enteroenteric fistulae, sinus tracts, strictures, postsurgical anatomy, and relation of recurrence to anastomosis. Computed tomography proved superior in demonstrating mesenteric inflammation, abscesses, enterovesical and enterocutaneous fistulae, fistula to iliopsoas muscle and to sacrum. We conclude that in the patient with suspected abscess, enterovesical or enterocutaneous fistula, CT is the study of choice. In other clinical circumstances both CT and contrast studies should be performed since they are complementary.
Orel
S G
SG
Russell H. Morgan Department of Radiology and Radiologic Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Rubesin
S E
SE
Jones
B
B
Fishman
E K
EK
Bayless
T M
TM
Siegelman
S S
SS
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001466:Barium Sulfate; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004064:Digestive System / Q000000981:diagnostic imaging; D004733:Enema; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
D001466:Barium Sulfate