Double contrast small-bowel radiography in the preoperative assessment of Crohn's disease: is it still useful?
OBJECTIVE
To evaluate the usefulness of double contrast small-bowel radiography (SBR) in the preoperative assessment of patients with Crohn's disease (CD).


METHODS
Thirty-nine consecutive patients who underwent surgery for CD between 2000 and 2004, preceded by a preoperative small-bowel series evaluation, were enrolled in our study. The radiologic findings were compared with the intraoperative findings.


RESULTS
Small-bowel radiography was associated with good specificity and sensitivity for the detection of stenosis. Although its main limitation was a remarkable overestimation of stenosis, the main indications for surgery were always confirmed. Sensitivity and specificity were lower for the detection of internal fistulas and the correlation was significant only for SBR performed within 3 months of the operation; however, the concordance between radiological and operative findings was greater. No correlation was observed for the detection of an abdominal mass.


CONCLUSIONS
Small-bowel radiography is still reliable for evaluating stenoses and internal fistulas. However, magnetic resonance imaging or computed tomography is mandatory to evaluate an abdominal mass.
Angriman
Imerio
I
Dipartimento di Scienze Chirurgiche e Gastroenterologiche P.G G. Cevese, Università di Padova, Via Giustiniani 2, 35128, Padova, Italy.
Scarpa
Marco
M
Ruffolo
Cesare
C
Pomerri
Fabio
F
Filosa
Teresa
T
Polese
Lino
L
Pagano
Duilio
D
Norberto
Lorenzo
L
D'Amico
Davide F
DF
D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D003287:Contrast Media; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008747:Methylcellulose; D008875:Middle Aged; D010347:Patient Care Planning; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D003287:Contrast Media; D001466:Barium Sulfate; D008747:Methylcellulose