Transabdominal bowel sonography for the detection of intestinal complications in Crohn's disease

Background—The course ofCrohn's disease is characterised by the occurrence of intestinalcomplications such as strictures, intra-abdominal fistulas, orabscesses. Standard diagnostic procedures may fail to show thesecomplications, in particular fistulas.
Aims—To test the value oftransabdominal bowel sonography (TABS) for the detection of intestinalcomplications in Crohn's disease.
Methods—TABS was prospectivelyperformed in 213 patients with Crohn's disease in a university basedinflammatory bowel disease referral centre. Thirty three underwentresective bowel surgery and were included in this study. The accuracyof TABS to detect strictures, intra-abdominal fistulas, or abscesseswas compared with surgical and pathological findings.
Results—TABS was able to identifystrictures in 22/22 patients and to exclude it in 10/11 patients (100%sensitivity, 91% specificity). Fistulas were correctly identified in20/23 patients and excluded in 9/10 patients (87% sensitivity, 90%specificity). Intra-abdominal abscesses were correctly detected in 9/9patients and excluded in 22/24 patients (100% sensitivity, 92% specificity).
Conclusions—In experienced handsTABS is an accurate method for the detection of intestinalcomplications in Crohn's disease. TABS is thus recommended as aprimary investigative method for evaluation of severe Crohn's disease.

Keywords:Crohn's disease complications; fistula; stricture; abscess; bowel sonography