The Role of Intestinal Ultrasonography in Children with Inflammatory Bowel Disease

Endoscopic and histopathological evaluation are important in the diagnosis and follow-up of inflammatory bowel disease (IBD), but they are invasive methods. This study aimed to evaluate the use of ultrasonography (USG), a noninvasive examination, in diagnosing and monitoring children with IBD.

The patients included IBD and non-IBD who underwent a prospective diagnostic colonoscopy. After colonoscopy, bowel wall thickness (BWT) of the patients was measured using USG. Ultrasonographic, endoscopic, histological, and laboratory findings were then compared.

Of the 62 patients who underwent colonoscopy, 25 (40.3%) were female. The mean age of the patients was 14.7 ± 3.5 years. Forty-three (69.4%) patients were diagnosed with ulcerative colitis, 12 (19.4%) with Crohn's disease. Seven (11.3%) patients had normal colonoscopy findings. The BWT of the terminal ileum, left colon, and sigmoid colon were significantly higher in children with IBD. The BWT cut-off was detected as 2.55 mm in the terminal ileum, 3.35 mm in the right colon, 2.5 mm in the left colon and 2.25 mm in the sigmoid colon. When BWT in the terminal ileum and left colon increased, histopathological inflammation was significantly detected. A moderate positive correlation was observed between the C-reactive protein, erythrocyte sedimentation rate, and platelet values and the BWT values.

Ultrasonography can be useful in the diagnosis of IBD patients. Specifically, BWT was found to be particularly sensitive and specific during the inflammatory period.