Small bowel stenosis in Crohn's disease: clinical, biochemical and ultrasonographic evaluation of histological features

Summary Aim : To establish whether intestinal ultrasound, clinical or biochemical indices of activity can assess histological features of ileal stenosis in Crohn's disease. Methods : In 43 patients undergoing surgery for a single ileal stenosis, clinical and biochemical parameters, as well as i...

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Bibliographic Details
Published in:Alimentary pharmacology & therapeutics 2003-10, Vol.18 (7), p.749-756
Main Authors: Maconi, G., Carsana, L., Fociani, P., Sampietro, G. M., Ardizzone, S., Cristaldi, M., Parente, F., Vago, G. L., Taschieri, A. M., Bianchi Porro, G.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Crohn Disease - diagnostic imaging
Crohn Disease - pathology
Crohn Disease - surgery
Female
Fibrosis - diagnostic imaging
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Ileal Diseases - diagnostic imaging
Ileal Diseases - pathology
Ileal Diseases - surgery
Ileitis - diagnostic imaging
Ileitis - pathology
Ileitis - surgery
Immunohistochemistry
Intestinal Obstruction - diagnostic imaging
Intestinal Obstruction - pathology
Intestinal Obstruction - surgery
Male
Medical sciences
Other diseases. Semiology
Preoperative Care - methods
Recurrence
Sensitivity and Specificity
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Ultrasonography
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Summary:Summary Aim : To establish whether intestinal ultrasound, clinical or biochemical indices of activity can assess histological features of ileal stenosis in Crohn's disease. Methods : In 43 patients undergoing surgery for a single ileal stenosis, clinical and biochemical parameters, as well as intestinal ultrasound, were assessed prior to surgery. The echo pattern of thickened bowel segments at the site of stenosis was classified as hypoechoic, stratified or mixed (segments with/without stratification). During surgery, stenoses were identified, resected and then histologically examined using standardized criteria. Results : Clinical and biochemical indices of activity showed an overall weak positive correlation with histological inflammatory parameters and a negative correlation with fibrosis. The intestinal ultrasound echo pattern at the stenosis site was stratified in 25 patients, hypoechoic in 14 and mixed in four. Stenoses characterized by a stratified echo pattern showed a significantly higher degree of fibrosis, those characterized by hypoechoic echo pattern showed a higher degree of inflammation, while stenoses with a mixed echo pattern showed high degrees of both fibrosis and inflammation. Conclusion : Ultrasound and, to a lesser degree, clinical and laboratory indices discriminate between inflammatory and fibrotic ileal stenoses complicating Crohn's disease, thus allowing appropriate medical and/or surgical treatment to be defined.
ISSN:0269-2813
1365-2036
DOI:10.1046/j.1365-2036.2003.01673.x