Ultrasonographic detection of intestinal complications in Crohn's disease

The aim of this study was to evaluate the sensitivity and specificity of ultrasound (US) in assessing the main abdominal complications of Crohn's disease (CD), such as strictures, fistulas and abscesses. A series of 98 consecutive inpatients with complicated and uncomplicated Crohn's disease, having undergone a complete endoscopic and radiographic evaluation of the intestinal tract, entered the study. In particular, in these patients the presence of strictures, fistulas, and abscesses, detected by means of colonoscopy, small bowel x-ray, double-contrast barium enema, and computed tomography, was also assessed by means of transabdominal US. US sensitivity and specificity in the assessment of stenosis of Crohn's disease were 74.4% and 93.1%, respectively. When ileal and colonic stenosis were considered separately, transabdominal US correctly assessed 84.6% of ileal stenosis and 58.8% of colonic stenosis. Eight of 12 fistulas were detected, but only 50% of enteroenteric fistulas were diagnosed. The presence of abscesses was correctly detected in 83.3% of cases by means of US. Our data suggest that US is a suitable complementary method for the detection of abdominal complications of Crohn's disease, such as strictures and abscesses; however, its usefulness in assessing enteroenteric fistulas seems to be fairly limited.