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

Background-The course of Crohn's disease is characterised by the occurrence of intestinal complications such as strictures, intra-abdominal fistulas, or abscesses. Standard diagnostic procedures may fail to show these complications, in particular fistulas. Aims-To test the value of transabdominal bowel sonography (TABS) for the detection of intestinal complications in Crohn's disease. Methods-TABS was prospectively performed in 213 patients with Crohn's disease in a university based inflammatory bowel disease referral centre. Thirty three underwent resective bowel surgery and were included in this study. The accuracy of TABS to detect strictures, intraabdominal fistulas, or abscesses was compared with surgical and pathological findings. Results-TABS was able to identify strictures in 22/22 patients and to exclude it in 10/11 patients (100% sensitivity, 91% specificity). Fistulas were correctly identified in 20/23 patients and excluded in 9/10 patients (87% sensitivity, 90% specificity). Intra-abdominal abscesses were correctly detected in 9/9 patients and excluded in 22/24 patients (100% sensitivity, 92% specificity). Conclusions-In experienced hands TABS is an accurate method for the detection of intestinal complications in Crohn's disease. TABS is thus recommended as a primary investigative method for evaluation of severe Crohn's disease.