Transabdominal bowel sonography for the detection of intestinal complications in Crohn's disease.
BACKGROUND
The course of Crohn's disease is characterised by the occurrence of intestinal complications such as strictures, intra-abdominal fistulas, or abscesses. Standard diagnostic procedures may fail to show these complications, in particular fistulas.


OBJECTIVE
To test the value of transabdominal bowel sonography (T) for the detection of intestinal complications in Crohn's disease.


METHODS
T was prospectively performed in 213 patients with Crohn's disease in a university based inflammatory bowel disease referral centre. Thirty three underwent resective bowel surgery and were included in this study. The accuracy of T to detect strictures, intra-abdominal fistulas, or abscesses was compared with surgical and pathological findings.


RESULTS
T was able to identify strictures in 22/22 patients and to exclude it in 10/11 patients (100% sensitivity, 91% specificity). Fistulas were correctly identified in 20/23 patients and excluded in 9/10 patients (87% sensitivity, 90% specificity). Intra-abdominal abscesses were correctly detected in 9/9 patients and excluded in 22/24 patients (100% sensitivity, 92% specificity).


CONCLUSIONS
In experienced hands T is an accurate method for the detection of intestinal complications in Crohn's disease. T is thus recommended as a primary investigative method for evaluation of severe Crohn's disease.
Gasche
C
C
Clinic of Internal Medicine IV, Department of Gastroenterology and Hepatology, Vienna, Austria.
Moser
G
G
Turetschek
K
K
Schober
E
E
Moeschl
P
P
Oberhuber
G
G
D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000209:etiology; D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography