Sound of Success: Intestinal Ultrasound in the Management of Refractory Stricturing Crohn's Disease

We present a case of a female with complex pediatric-onset stricturing small bowel and colonic Crohn's disease. She was refractory to multiple advanced therapies, requiring dual therapy with risankizumab and upadacitinib to induce healing. Using intestinal ultrasound to monitor her response to therapy, we ultimately de-escalated to risankizumab monotherapy due to a reduction of inflammatory burden. We present this case to highlight the use and importance of intestinal ultrasound to guide changes in therapy, discussing its use in practice for patients with inflammatory bowel disease.