TITLE

Contrast radiology, computed tomography and ultrasonography in detecting internal fistulas and intra-abdominal abscesses in Crohn’s disease: a prospective comparative study

AUTHOR(S)
Maconi, Giovanni; Sampietro, Gianluca M.; Parente, Fabrizio; Pompili, Giovanni; Russo, Antonio; Cristaldi, Massimo; Arborio, Giancarlo; Ardizzone, Sandro; Matacena, Giovanni; Taschieri, Angelo Maria; Bianchi Porro, Gabriele
PUB. DATE
July 2003
SOURCE
American Journal of Gastroenterology;Jul2003, Vol. 98 Issue 7, p1545
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
: ObjectivesAccurate assessment of intestinal complications of Crohn’s disease (CD) is extremely important, both in clinical practice and in trials. The accuracy of radiographic and ultrasonographic diagnosis of internal fistulae and abscesses complicating CD is still debated and requires further investigation. We compared ultrasonography (US) and contrast radiography in detecting intestinal fistulae and abscesses complicating CD.: MethodsA prospective study was carried out on 625 consecutive CD patients who underwent complete evaluation of the intestinal tract by means of colonoscopy and double contrast barium enema, small bowel enteroclysis, and abdominal ultrasound (US). Computed tomography (CT) was also carried out in cases of severe CD with clinical suspicion of septic complications. The accuracy of US, barium radiology, and CT in detecting internal fistulae and abscesses was assessed by comparing results with intraoperative findings in 128 consecutive patients who underwent operation immediately after diagnostic workup.: ResultsInternal fistulae and intra-abdominal abscesses were identified intraoperatively in 56 (43.7%) and 26 (20.3%) patients, respectively. Diagnostic accuracy of US and x-ray studies in detecting internal fistulae was comparable (85.2% vs 84.8%), with sensitivity of 71.4% for US and 69.6% for x-ray studies, and specificity of 95.8% for both. Combination of radiographic techniques and US significantly improved diagnostic accuracy in detection of internal fistulae. In severe cases of CD with clinical suspicion of septic complications such as abdominal mass or fever, the accuracy of US, barium studies, and CT was 88.5%, 80.3%, and 77%, respectively (p = ns). The presence of abscesses was correctly detected in 90.9% of cases by means of US and in 86.4% by CT (p = ns), although accuracy was higher for CT (91.8%) than for US (86.9%) because of false positive results in US studies.: ConclusionDespite the fact that barium radiology is widely considered the method of choice in detection of internal fistulae, accuracy is not entirely satisfactory. Comparable accuracy was found for US and CT. The combination of barium and US studies, or the sole use of US in more CD patients with more severe disease, can reliably detect most internal fistulae and abscesses.
ACCESSION #
10234245

 

Related Articles

  • Tender Thigh in a Patient With Crohn's Disease. Al-Saeed, Abdulwahed; Helmy, Ahmed; Al-Ashgar, Hamad; Al-Kahtani, Khalid // Saudi Journal of Gastroenterology;Oct2008, Vol. 14 Issue 4, p214 

    A quiz about the radiologic findings and management of a patient with fistulizing Crohn's disease is presented.

  • THE ROLE OF POSITRON EMISSION TOMOGRAPHY IN INFLAMMATORY BOWEL DISEASE. CISTARO, A.; QUARTUCCIO, N.; MANSI, L.; SIGNORE, A.; DOLCI, M.; TREGLIA, G. // European Journal of Inflammation (BIOLIFE, s.a.s.);Sep-Dec2012, Vol. 10 Issue 3, p251 

    Inflammatory bowel diseases (IBD) are a group of pathological conditions characterized by chronic inflammation of the gastrointestinal tract, including Crohn's disease and ulcerative colitis. To date, imaging of IBD is based on several radiological techniques such as barium studies, magnetic...

  • Pediatric Radiology Continuing Medical Education Activity.  // Pediatric Radiology;Oct2014, Vol. 44 Issue 10, p1195 

    The article describes an activity program for continuing medical education which asks participants to review normal peri-anal anatomy, desribe peri-anal Crohn complication classification system and show Crohn disease magnetic resonance imaging.

  • A "false positive" octreoscan in ileal Crohn's disease. Fernandez, Alberto; Tabuenca, Olga; Peteiro, Angeles; De Hertogh, Gert // World Journal of Gastroenterology;9/14/2008, Vol. 14 Issue 34, p5349 

    We present a case report of a patient with a suspicious ileal carcinoid tumour. Clinical examination as well as computer tomograghy (CT) scan suggested a tumour. Octeotride scan showed uptake in the same bowel loop reported as pathological in CT. The patient underwent surgery and biopsy which...

  • Spontaneous mesenteric hematoma complicating an exacerbation of Crohn's disease: report of a case. Ashrafian, Hutan; Manfield, James H. R.; Mitra, Anuja; Boyle, Derek J.; Mathur, Pawan // BMC Surgery;2014, Vol. 14 Issue 1, p1 

    Spontaneous mesenteric haematoma is a rare condition that occurs due to localized bleeding in the mesenteric vascular tree of a bowel segment in the absence of an identifiable cause. Here we report a case of spontaneous mesenteric haematoma during an inflammatory exacerbation of Crohn's disease....

  • The place of interventional radiology in Crohn disease in children. Rypens, F.; Dubois, J.; Garel, L. // Pediatric Radiology;Nov2007, Vol. 37 Issue 11, p1093 

    The interventional radiologist plays an important role in the treatment of complicated Crohn disease in children. Interventional radiology includes percutaneous drainage of abscesses and insertion of suitable intravenous lines. A multidisciplinary approach is mandatory for the management of...

  • Computed Tomographic Findings of Abdominal Complications of Crohn's Disease--Pictorial Essay. Zissin, Rivka; Hertz, Marjorie; Osadchy, Alexandra; Novis, Ben; Gayer, Gabriela // Canadian Association of Radiologists Journal;Feb2005, Vol. 56 Issue 1, p25 

    Focuses on the use of computed tomography in the diagnosis of abdominal complications of Crohn's disease. Details on the diagnostic accuracy of various intra-abdominal pathological processes; Evaluation and management of patients with known CD for the assessment of bowel wall involvement;...

  • Computed Tomography in Crohn's Disease. Berliner, Leonard; Redmond, Patricia; Purow, Elias; Megna, Daniel; Sottile, Vincent // American Journal of Gastroenterology;Aug1982, Vol. 77 Issue 8, p548 

    Computed tomography, barium examinations, and endoscopy play complementary roles in documenting the extent of disease in patients with Crohn's disease. Computed tomography is most often requested for patients with suspected or known intraabdominal or pelvic abscesses. In addition to documenting...

  • Postoperative enteroenteric intussusception in patients with Crohn’s disease: Report of two cases. Motoi Uchino; Hiroki Ikeuchi; Hiroki Matsuoka; Keita Tanaka; Takashi Kuno; Tsutomu Ohshima; Kiyoshi Tsukamoto; Mitsuhiro Nakamura; Makoto Gega; Toshihiko Yagyu; Hiroki Nakano; Masafumi Noda; Naohiro Tomita // Surgery Today;Feb2008, Vol. 38 Issue 4, p366 

    Abstract  Postoperative enteroenteric intussusception is a rare complication in adult patients with Crohn’s disease. We treated two patients with Crohn’s disease accompanied by an ileal obstruction, each of whom underwent an elective resection. In both, the upper left...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics