[Significance of computerized tomography in the study of Crohn disease]

Twenty-six patients affected with Crohn's disease were studied by means of CT. The method demonstrated transmural fistulas in 2 cases, and bowel wall thickening in all patients. In our series of cases, the advantages of CT over conventional radiology lay in the fact that the former allowed the evaluation of associated mesenteric pathologies (e.g. fibrofatty proliferation, and adenopathies) and demonstrated the presence of abscesses in 4 case. CT findings were in agreement with those from conventional contrast studies in the demonstration of entero-enteric fistulas, whereas they yielded additional information in the study of entero-muscular fistulas. Associated pathologies in other organs were found in 5 patients--i.e. fatty infiltration of the liver and cholelithiasis. CT is not useful in demonstrating early mucosal damage in Crohn's disease, but it should be regarded as a complementary method to conventional barium studies. As a matter of fact, CT is fundamental in the evaluation of associated mesenteric pathologies and of other complications which can affect therapeutic management.