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Published on: August 29, 2025
[Sonography of small bowel, colon and appendix in children with cystic fibrosis]
Maria Uliasz1, Hanna Bragoszewska, Beata Iwanowska
1Zaklad Diagnostyki Obrazowej IMiD. mariauliasz@wp.pl
Insights
Sonography effectively detects frequent intestinal changes in children with cystic fibrosis (CF). This imaging is crucial for annual CF follow-up and aids in diagnosing unidentified CF cases.
Area of Science:
- Pediatric gastroenterology
- Medical imaging
- Genetics and hereditary diseases
Background:
- Cystic fibrosis (CF) is a genetic disorder affecting multiple organs, particularly the gastrointestinal tract.
- Early and accurate diagnosis of CF-related complications is essential for effective management.
- Sonography offers a non-invasive method for evaluating abdominal pathology.
Purpose of the Study:
- To evaluate the diagnostic utility of sonography in identifying and characterizing intestinal and abdominal organ abnormalities in pediatric patients with cystic fibrosis.
- To determine the incidence of pathological changes in the intestines and other abdominal organs in children with CF.
- To assess the role of abdominal sonography in the diagnosis of unidentified CF cases.
Main Methods:
- A cohort of 182 children (2 months to 22 years) with diagnosed or suspected cystic fibrosis underwent sonographic examinations.
- A control group of 20 children was included for comparison.
- Philips ultrasound equipment with various probes was utilized over a 2.5-year period, with multiple examinations performed on some patients.
Main Results:
- Intestinal changes were observed in 59.3% of children with CF, including colon (53.3%) and small intestine (26.9%) abnormalities.
- Significantly increased intestinal wall thickness was noted in CF patients compared to controls.
- Abnormalities in the liver (39%) and pancreas (62.6%) were frequently identified, alongside enlarged mesenteric lymph nodes (46%).
Conclusions:
- Sonography reveals a high prevalence of intestinal and abdominal organ changes in children with cystic fibrosis.
- Routine annual sonographic examination should be incorporated into the follow-up care of pediatric CF patients.
- Abdominal sonography is a valuable tool for diagnosing cystic fibrosis when the condition is not initially identified.
Aim:
To assess the utility of sonographic examination in estimation of the incidence and character of pathological changes in different parts of the intestine and other abdominal organs in children with cystic fibrosis (CF).
Material And Method:
The study group consisted of 182 children (94 girls, 88 boys), aged from 2 months up to 22 yrs, with diagnosed cystic fibrosis or its suspicion, confirmed later. The control group consisted of 20 children with mean age 8 yrs. Sonography was performed with Philips equipment: 4000 HDI and iU 22 using convex, microconvex and linear probes. 329 examinations were performed in 182 children in 2.5 years, 109 underwent second US and 38 patients were examined for the third time.
Results:
In children with CF, changes in the intestines were observed in 108 patients (59.3%), in the colon in 97 patients (53.3%), and in the small intestine in 49 patients (26.9%). In the control group the wall thickness of large intestine did not surpass 1.6 mm, of small intestine--1.4 mm. In the tested group the maximum thickness of large intestine wall was 7 mm and of small intestine--4.3 mm. Layer structure of the ileum wall was found in 46 children (25%), enlarged appendix in 21 patients (11.6%). Enlarged mesenteric lymph nodes were observed in 84 pts (46%). Hyperaemia of the bowel wall was not observed on Power Doppler examination. In 71 patients (39%) changes in the structure of the liver were observed (cirrhosis, steatosis, enlargement) and in 114 (62.6%) there were changes in the pancreas.
Conclusions:
Sonographic examination in patients with cystic fibrosis revealed a high frequency of intestinal changes which confirms the need of including this examination in the annual follow-up of children with CF. In cases of unidentified CF, abdominal sonography leads to the diagnosis.
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