Inflammatory bowel diseases: the paediatric gastroenterologist's perspective.

Area of Science:

• Pediatric Radiology
• Gastroenterology
• Medical Imaging

Background:

• Inflammatory bowel diseases (IBD), encompassing Crohn disease (CD) and ulcerative colitis (UC), frequently impact pediatric populations.
• Accurate diagnosis of IBD in children relies on a multidisciplinary approach integrating clinical, biological, endoscopic, histological, and radiological findings.
• Paediatric radiologists play a vital role in the diagnostic and management pathway of IBD in young patients.

Purpose of the Study:

• To elucidate the multifaceted contributions of paediatric radiology in the diagnosis and management of IBD in children and adolescents.
• To highlight the utility of various imaging modalities, including ultrasound and advanced techniques, in the diagnostic workup and follow-up of pediatric IBD.
• To emphasize the importance of radiological assessment in differentiating between CD and UC and in classifying disease subphenotypes.

Main Methods:

• Utilizing ultrasound (US) for initial gut exploration to identify children who may benefit from more invasive procedures like endoscopy.
• Employing small bowel imaging techniques to distinguish between CD and UC and to classify disease subphenotypes.
• Leveraging new imaging methodologies for assessing disease activity and diagnosing complications during patient follow-up.

Main Results:

• Ultrasound can effectively identify children with IBD symptoms, guiding decisions for further investigations.
• Small bowel imaging is crucial for accurate differentiation between CD and UC and for subtyping the disease.
• Advanced imaging techniques provide valuable insights into disease activity and complications, aiding in patient management.

Conclusions:

• Paediatric radiology is indispensable in the comprehensive diagnosis and management of IBD in children.
• Imaging modalities, from ultrasound to advanced techniques, offer critical information for diagnosis, subtyping, and monitoring of pediatric IBD.
• Radiological evaluation significantly impacts clinical decision-making and patient outcomes in pediatric IBD.