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Can J Gastroenterol Hepatol. 2016;2016:8745972. doi: 10.1155/2016/8745972. Epub 2016 Apr 19.

Impact of Intestinal Ultrasound on Classification and Management of Crohn's Disease Patients with Inconclusive Colonoscopy.

Author information

1
Department of Radiology, University of Calgary, Calgary, AB, Canada T2N 2T9; Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada T2N 2T9; Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, 8600 Silkeborg, Denmark; Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8000 Aarhus C, Denmark.
2
Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada T2N 2T9.
3
Department of Radiology, University of Calgary, Calgary, AB, Canada T2N 2T9.
4
Department of Radiology, University of Calgary, Calgary, AB, Canada T2N 2T9; Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada T2N 2T9.

Abstract

BACKGROUND AND AIMS:

We aim to evaluate the benefit of ultrasound in the assessment of Crohn's disease and to demonstrate its potential contribution to disease management.

METHODS:

We conduct a retrospective review of adult patients with Crohn's disease examined with sonography and colonoscopy within 30 days. Study patients were identified in whom colonoscopy did not access a pathological segment, detected and evaluated by ultrasonography. Changes in management were predominantly attributed to ultrasound in those cases where the diseased segment was not assessed on endoscopy.

RESULTS:

From 115 patients with temporally related ileocolonoscopy and ultrasound, 41 had disease fully assessed on ultrasound only, with complications in 26/41. Twenty-nine of 41 had mild or no endoscopic inflammation with moderate or severe disease on ultrasound at the same segment or at a segment proximal to the reach of the endoscope. Changes in management were significantly attributed to ultrasound in 22 of these 29 patients.

CONCLUSION:

The benefit of cross-sectional imaging is invaluable for the comprehensive assessment of bowel not shown on ileocolonoscopy. Ultrasound may make a significant contribution to correct classification of disease extent and severity of Crohn's disease. Prospective studies are needed to further understand the contribution of US in patient management.

PMID:
27446873
PMCID:
PMC4904685
DOI:
10.1155/2016/8745972
[Indexed for MEDLINE]
Free PMC Article

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