Abstract
OBJECTIVES: Abdominal ultrasound can assess the extent and localization of Crohn's disease, and an increased bowel wall thickness is the most common finding. Our aim was to correlate bowel wall thickness at ultrasound, with the risk of short-term surgical outcome in patients with Crohn's disease. MATERIALS From 1997 to 2000 we performed ultrasound in 174 consecutive patients with Crohn's disease. AND METHODS: Surgical operations were recorded over a 1-yr follow-up. Logistic regression analysis was performed to identify clinical and ultrasound risk factors for surgery. RESULTS: Fifty-two patients underwent surgery within 1 yr. Indication for surgery was strictures in most of the cases. Median bowel wall thickness was higher in patients with surgery (8 mm) than those without surgery (6 mm) (p <0.0001). A receiver operating characteristic (ROC) curve was constructed taking into account bowel wall thickness for selecting patients with a high risk of surgery. The optimized cut-off for equally important sensitivity and specificity was calculated at 7.008 mm. The binary regression analysis showed that CDAI > 150, absence of previous surgery, stricturing-penetrating pattern, the presence of intestinal complications, and intestinal wall thickness >7 mm were associated with an increased risk of surgery. Patients with intestinal wall thickness >7 mm at ultrasound had the highest risk (OR: 19.521, 95% Cl: 5.362-71.065). CONCLUSIONS: Data suggest that bowel wall thickness >7 mm at ultrasound is a risk factor for intestinal resection over a short period of time. Routine use of abdominal ultrasound during evaluation of patients with Crohn's disease may identify a subgroup that is at high risk for surgery.
| Original language | English |
|---|---|
| Pages (from-to) | 1977-1983 |
| Number of pages | 7 |
| Journal | American Journal of Gastroenterology |
| Volume | 99 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 2004 |
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ASJC Scopus subject areas
- Gastroenterology
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Bowel wall thickness at abdominal ultrasound and the one-year-risk of surgery in patients with Crohn's disease. / Castiglione, Fabiana; De Sio, Ilario; Cozzolino, Antonio; Rispo, Antonio; Manguso, Francesco; Blanco, Giovanna Del Vecchio; Di Girolamo, Elena; Castellano, Luigi; Ciacci, Carolina; Mazzacca, Gabriele.
In: American Journal of Gastroenterology, Vol. 99, No. 10, 10.2004, p. 1977-1983.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Bowel wall thickness at abdominal ultrasound and the one-year-risk of surgery in patients with Crohn's disease
AU - Castiglione, Fabiana
AU - De Sio, Ilario
AU - Cozzolino, Antonio
AU - Rispo, Antonio
AU - Manguso, Francesco
AU - Blanco, Giovanna Del Vecchio
AU - Di Girolamo, Elena
AU - Castellano, Luigi
AU - Ciacci, Carolina
AU - Mazzacca, Gabriele
PY - 2004/10
Y1 - 2004/10
N2 - OBJECTIVES: Abdominal ultrasound can assess the extent and localization of Crohn's disease, and an increased bowel wall thickness is the most common finding. Our aim was to correlate bowel wall thickness at ultrasound, with the risk of short-term surgical outcome in patients with Crohn's disease. MATERIALS From 1997 to 2000 we performed ultrasound in 174 consecutive patients with Crohn's disease. AND METHODS: Surgical operations were recorded over a 1-yr follow-up. Logistic regression analysis was performed to identify clinical and ultrasound risk factors for surgery. RESULTS: Fifty-two patients underwent surgery within 1 yr. Indication for surgery was strictures in most of the cases. Median bowel wall thickness was higher in patients with surgery (8 mm) than those without surgery (6 mm) (p <0.0001). A receiver operating characteristic (ROC) curve was constructed taking into account bowel wall thickness for selecting patients with a high risk of surgery. The optimized cut-off for equally important sensitivity and specificity was calculated at 7.008 mm. The binary regression analysis showed that CDAI > 150, absence of previous surgery, stricturing-penetrating pattern, the presence of intestinal complications, and intestinal wall thickness >7 mm were associated with an increased risk of surgery. Patients with intestinal wall thickness >7 mm at ultrasound had the highest risk (OR: 19.521, 95% Cl: 5.362-71.065). CONCLUSIONS: Data suggest that bowel wall thickness >7 mm at ultrasound is a risk factor for intestinal resection over a short period of time. Routine use of abdominal ultrasound during evaluation of patients with Crohn's disease may identify a subgroup that is at high risk for surgery.
AB - OBJECTIVES: Abdominal ultrasound can assess the extent and localization of Crohn's disease, and an increased bowel wall thickness is the most common finding. Our aim was to correlate bowel wall thickness at ultrasound, with the risk of short-term surgical outcome in patients with Crohn's disease. MATERIALS From 1997 to 2000 we performed ultrasound in 174 consecutive patients with Crohn's disease. AND METHODS: Surgical operations were recorded over a 1-yr follow-up. Logistic regression analysis was performed to identify clinical and ultrasound risk factors for surgery. RESULTS: Fifty-two patients underwent surgery within 1 yr. Indication for surgery was strictures in most of the cases. Median bowel wall thickness was higher in patients with surgery (8 mm) than those without surgery (6 mm) (p <0.0001). A receiver operating characteristic (ROC) curve was constructed taking into account bowel wall thickness for selecting patients with a high risk of surgery. The optimized cut-off for equally important sensitivity and specificity was calculated at 7.008 mm. The binary regression analysis showed that CDAI > 150, absence of previous surgery, stricturing-penetrating pattern, the presence of intestinal complications, and intestinal wall thickness >7 mm were associated with an increased risk of surgery. Patients with intestinal wall thickness >7 mm at ultrasound had the highest risk (OR: 19.521, 95% Cl: 5.362-71.065). CONCLUSIONS: Data suggest that bowel wall thickness >7 mm at ultrasound is a risk factor for intestinal resection over a short period of time. Routine use of abdominal ultrasound during evaluation of patients with Crohn's disease may identify a subgroup that is at high risk for surgery.
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U2 - 10.1111/j.1572-0241.2004.40267.x
DO - 10.1111/j.1572-0241.2004.40267.x
M3 - Article
VL - 99
SP - 1977
EP - 1983
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 10
ER -