title: Clinical usefulness of classification by transabdominal ultrasonography for detection of small-bowel stricture.
abstract: OBJECTIVE
  To assess the clinical usefulness of transabdominal ultrasonography (TUS) for detection of small-bowel stricture.
  
  
  METHODS
  Subjects were 796 patients undergoing double-balloon endoscopy (DBE), December 2003-October 2011. All underwent TUS prior to DBE. The TUS findings were classified by type as intestinal narrowing and distension at the oral side (Type A); extensive bowel wall thickening (Type B); focal bowel wall thickening (Type C) or no abnormality detected (Type D). We compared TUS findings against DBE findings with respect to small-bowel stricture, defined as failure of the enteroscope to pass through the small bowel.
  
  
  RESULTS
  Small-bowel stricture was detected by DBE in 11.3% (90/796) of patients. Strictures resulted from Crohn's disease (n = 36), intestinal tuberculosis (n = 24), malignant lymphoma (n = 9), ischemic enteritis (n = 6), NSAID ulcer (n = 5), radiation enteritis (n = 2), surgical anastomosis (n = 2) and other abnormalities (n = 6). Stricture was detected by TUS in 93.3% (84/90) of patients, and each such stricture fell into one of the three types of TUS abnormality. The remaining 6 strictures were detected only by DBE. DBE-identified strictures corresponded to TUS findings as follows: 100% (43/43) to Type A, 59.1% (29/49) to Type B, 14.8% (12/81) to Type C and 1% (6/623) to Type D. Correspondence between stricture and the Type A classification (vs. Types B, C and D) was significantly high, as was correspondence between stricture and Type B (vs. Types C and D).
  
  
  CONCLUSIONS
  TUS was shown to be useful for detecting small-bowel stricture. We recommend performing TUS first when a small-bowel stricture is suspected.
authors.affiliation: Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University , Hiroshima , Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakano
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Taiki
authors.initials: T
authors.lastname: Aoyama
authors.forename: Ikue
authors.initials: I
authors.lastname: Watari
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hayashi
authors.forename: Rie
authors.initials: R
authors.lastname: Miyaki
authors.forename: Kenta
authors.initials: K
authors.lastname: Nagai
authors.forename: Yoji
authors.initials: Y
authors.lastname: Sanomura
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yoshida
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Ueno
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D002648:Child; D003251:Constriction, Pathologic / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology; D003424:Crohn Disease / Q000150:complications; D058582:Double-Balloon Enteroscopy; D004751:Enteritis / Q000150:complications; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000528:radiation effects; D008223:Lymphoma / Q000150:complications; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000139:chemically induced / Q000150:complications; D011832:Radiation Injuries / Q000150:complications; D012680:Sensitivity and Specificity; D014385:Tuberculosis, Gastrointestinal / Q000150:complications; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal