The role of computed tomography in management of patients with Crohn disease

Twenty-five patients with Crohn disease were studied using computed tomography (CT). Assessment of bowel wall thickening, enlargement of the mesenteric lymph nodes, and clearness of the mesenteric vascular contour was carried out in all patients. Evidence of inflammatory reaction of the mesenteric fat was seen in 23 patients (92%) and fibrofatty proliferation was observed in seven patients (28%). Nine patients underwent surgery when symptoms and signs were severe and of long duration, while 16 patients were treated conservatively. Degree of increase in fat density, clearness of the mesenteric vascular bundles, and enlargement of the mesenteric lymph nodes were seen more frequently in the surgical group of patients. CT shows improvement of inflammatory changes after conservative therapy in some cases. A large pseudodiverticulum, pseudopolyps, and a fistula formation were also observed in some cases. CT is an important diagnostic tool in the management of patients with Crohn disease.