[Sonography of chronic inflammatory bowel diseases--a prospective study]

In a prospective study, 118 patients with Crohn's disease, 51 patients with ulcerative colitis, and 72 patients with no disease of the intestine proximal to the rectum, were investigated by ultrasound. In Crohn's disease, thickening of the bowel wall and inflammatory conglomerates were detected in 72.0% of the patients. Using a transducer with optimal imaging properties these findings were detected in 87.2% of a group of 47 patients. Additionally an abscess was found in 5 patients. In ulcerative colitis, bowel wall thickening was detected in 52.9% of all patients. In both conditions, the extent of the mural changes was recognized completely in individual cases only. In Crohn's disease, the wall thickening was, on the whole, more marked, and an accumulation of pathological findings was found in the right lower abdomen. In the case of ulcerative colitis, on the other hand, the wall thickening was less pronounced, and located particularly in the left lateral abdomen. In the comparative group, low-grade thickening of the wall was observed in 3 cases only. The ultrasonographic image permits no conclusions to be drawn as to the degree of activity of the disease, although, in ulcerative colitis, the number of positive findings increases with increasing activity. No correlation of the findings with the duration of the disease was established. Considerably increased wall thickness if localized in the right lower quadrant and found in combination with an inflammatory conglomerate or an abscess, suggests Crohn's disease. It is not possible to exclude either disease by means of ultrasound.