Sonographic evaluation of bowel wall thickness in patients with cystic fibrosis.
OBJECTIVE
Fibrosing colonopathy causing severe thickening of the colon wall was recently described in cystic fibrosis (CF). Since it has been suspected that subclinical colon-wall thickening is a common feature in CF patients, bowel-wall thickness was measured in a series of patients and compared with controls. Additionally, possible clinical factors influencing wall thickness were investigated.


METHODS
In 83 CF patients and 31 controls transabdominal ultrasound was performed in the terminal ileum, cecum, ascending and descending colon. The relation of the measured wall thickness to age, sex, pancreatic enzyme intake, and intestinal diseases was analyzed.


RESULTS
In controls, mean wall thickness depending on gut region was 1.1 to 1.3 mm (SD 0.19-0.23). In CF patients, no evidence of severe thickening or stricture was found, but wall thickness was significantly higher than in controls in all measured regions (1.5-1.6 mm; SD 0.31-0.41). Patients with meconium ileus and distal intestinal obstruction syndrome had significantly increased thickness of the terminal ileum compared with patients without these complications. Neither the intake of high-strength enzymes nor enzyme dosage, age or sex were associated with wall thickness.


CONCLUSIONS
We found no evidence that a subclinical stage of fibrosing colonopathy is prevalent among the CF patients. Slightly thickened gut walls in CF can be interpreted as an expression of glandular dysfunction in the CF intestine.
Dialer
Irmela
I
Universities Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Munich, Germany.
Hundt
Cornelia
C
Bertele-Harms
Rose-Marie
RM
Harms
Hinrich Karsten
HK
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002432:Cecum / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000473:pathology; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology; D007223:Infant; D007422:Intestines / Q000473:pathology*; D008297:Male; D011446:Prospective Studies; D014463:Ultrasonography