Abdominal bowel ultrasound can predict the risk of surgery in crohn's disease: Proposal of an ultrasonographic score

Caterina Rigazio, Elena Ercole, Cristiana Laudi, Marco Daperno, Alessandro Lavagna, Lucia Crocellà, Franco Bertolino, Luca Viganò, Raffaello Sostegni, Angelo Pera, Rodolfo Rocca

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. Abdominal bowel ultrasound (US) is widely used in the management of Crohn's disease (CD). The aim of this study was to evaluate the prognostic role of bowel-wall US morphology on the short-term risk of surgery. Material and methods. The 147 CD patients recruited in a case-control study comprised 49 cases operated on within 30 days after US examination and 98 matched non-operated controls. Clinical and US characteristics were analysed. Bowel-wall thickness was recorded, bowel-wall patterns were grouped into five types, but for final analysis they were grouped as preserved or disrupted stratification. Results. Wall thickness and US patterns were significantly different between cases and controls (p0.0001). A wall thickness 4.5 mm was observed in 45/49 cases and 47/98 controls (OR = 12.21), while disrupted stratification was observed in 34/49 cases and 12/98 controls (OR = 16.24). Among the clinical and US characteristics recorded, only 4 US variables were independently associated with surgery (pattern, thickness, presence of fistulae/abscesses and stenoses) and considered for the US score=(2.5*US pattern)+(1.5*Bowel thickness)+(3*Presence of fistulae/abscesses)+(1.5*Presence of stenoses). Based on this score, up to 84% of patients were correctly classified according to actual status (operated/non-operated). Conclusions. Although it needs further prospective validation, the score we propose seems to be a reliable prognostic marker for the short-term risk of surgery in CD. In particular, the score points out those patients with an impending risk of surgery who need careful and frequent control in order to decide on the right time for surgery.

Original languageEnglish
Pages (from-to)585-593
Number of pages9
JournalScandinavian Journal of Gastroenterology
Volume44
Issue number5
DOIs
Publication statusPublished - May 2009

Keywords

  • Bowel wall
  • Crohn's disease
  • Prognosis
  • Surgery
  • Ultrasonography

ASJC Scopus subject areas

  • Gastroenterology

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