title: Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in crohn's disease: a prospective comparative study versus intraoperative findings.
abstract: BACKGROUND
  In Crohn's disease (CD) patients, small intestine contrast ultrasonography (SICUS) accurately assesses small bowel lesions. Its diagnostic role is not known in the assessment of intraabdominal CD complications. The aim was to assess the value of SICUS to detect intestinal complications in patients with CD.
  
  
  METHODS
  Forty-nine CD patients (21 female, mean age 37.7 years; range 12-78 years) underwent resective bowel surgery and were included in this study. The accuracy of SICUS to preoperatively detect number, site, and length of strictures, fistulas, and abscesses was compared with surgical and pathological findings by kappa statistics.
  
  
  RESULTS
  SICUS identified at least one stricture in 39/40 and excluded it in 9/9 (97.5% sensitivity, 100% specificity, k = 0.93); two or more strictures in 9/12 (75% sensitivity, 100% specificity, k = 0.78). The agreement by k-statistics between SICUS and surgery in identifying proximal and distal small intestine site of stricture was 1 and 0.92, respectively. The extension of strictures was 6.8 ± 5.4 cm at surgery, 6.6 ± 5.4 cm at SICUS (NS). Fistulas were correctly identified in 27/28 patients and excluded in 19/21 patients (96% sensitivity, 90.5% specificity, k = 0.88). Intraabdominal abscesses were correctly detected in 10/10 patients and excluded in 37/39 patients (100% sensitivity, 95% specificity, k = 0.89).
  
  
  CONCLUSIONS
  SICUS is an accurate method for the detection of small intestinal complications in CD. Noninvasive SICUS is valuable as a primary investigative method for evaluating and planning proper treatment in patients with severe CD of the small bowel.
authors: Dipt. Medicina Interna e Specialità Mediche Università "Sapienza," Rome Italy.
authors: Nadia
authors: N
authors: Pallotta
authors: Giuseppina
authors: G
authors: Vincoli
authors: Chiara
authors: C
authors: Montesani
authors: Piero
authors: P
authors: Chirletti
authors: Annamaria
authors: A
authors: Pronio
authors: Roberto
authors: R
authors: Caronna
authors: Barbara
authors: B
authors: Ciccantelli
authors: Erminia
authors: E
authors: Romeo
authors: Adriana
authors: A
authors: Marcheggiano
authors: Enrico
authors: E
authors: Corazziari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003287:Contrast Media; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D003287:Contrast Media