Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in crohn's disease: A prospective comparative study versus intraoperative findings

Nadia Pallotta, Giuseppina Vincoli, Chiara Montesani, Piero Chirletti, Annamaria Pronio, Roberto Caronna, Barbara Ciccantelli, Erminia Romeo, Adriana Marcheggiano, Enrico Corazziari

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In Crohn's disease (CD) patients, small intestine contrast ultrasonography (SICUS) accurately assesses small bowel lesions. Its diagnostic role is not known in the assessment of intraabdominal CD complications. The aim was to assess the value of SICUS to detect intestinal complications in patients with CD. Methods: Forty-nine CD patients (21 female, mean age 37.7 years; range 12-78 years) underwent resective bowel surgery and were included in this study. The accuracy of SICUS to preoperatively detect number, site, and length of strictures, fistulas, and abscesses was compared with surgical and pathological findings by kappa statistics. Results: SICUS identified at least one stricture in 39/40 and excluded it in 9/9 (97.5% sensitivity, 100% specificity, k = 0.93); two or more strictures in 9/12 (75% sensitivity, 100% specificity, k = 0.78). The agreement by k-statistics between SICUS and surgery in identifying proximal and distal small intestine site of stricture was 1 and 0.92, respectively. The extension of strictures was 6.8 ± 5.4 cm at surgery, 6.6 ± 5.4 cm at SICUS (NS). Fistulas were correctly identified in 27/28 patients and excluded in 19/21 patients (96% sensitivity, 90.5% specificity, k = 0.88). Intraabdominal abscesses were correctly detected in 10/10 patients and excluded in 37/39 patients (100% sensitivity, 95% specificity, k = 0.89). Conclusions: SICUS is an accurate method for the detection of small intestinal complications in CD. Noninvasive SICUS is valuable as a primary investigative method for evaluating and planning proper treatment in patients with severe CD of the small bowel.

Original languageEnglish
Pages (from-to)74-84
Number of pages11
JournalInflammatory Bowel Diseases
Volume18
Issue number1
DOIs
Publication statusPublished - Jan 2012

Keywords

  • Crohn's disease
  • small intestine, morphology, pathology
  • ultrasonography, SICUS

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

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