COLONIC WALL THICKNESS MEASURED BY ULTRASOUND - STRIKING DIFFERENCES IN PATIENTS WITH CYSTIC-FIBROSIS VERSUS HEALTHY CONTROLS

Background-Colonic strictures represent an advanced stage of fibrosing colonopathy in patients with cystic fibrosis. Aims-To clarify whether ultrasonography can identify patients with an early stage of fibrosin g colonopathy and to determine clinical factors that influence bowel w all thickening. Patients-Ninety patients with cystic fibrosis, median age 10 years, and 46 healthy controls, median age 13 years, were inves tigated. Methods-Bowel wall thickness was measured by ultrasound in a prospective study. Results-In cystic fibrosis, wall thickness of both small intestine and colon was significantly (p<0 . 0001) higher than i n controls; 81% of patients with cystic fibrosis had a maximum colon w all thickness at any site of 2 mm or more, a value that was never reac hed by controls. The maximum colon wall thickness was 6 . 5 mm. Bowel wall thickness was unchanged at re-examination after one year. There w as no progression even with high dose pancreatic supplements. There wa s no association between bowel wall thickness and clinical features su ch as previous meconium ileus, intestinal resection, distal intestinal obstruction syndrome, abdominal pain, or pancreatic enzyme dose. Conc lusions-There is genuine intestinal involvement in cystic fibrosis; in a few cases this could lead to fibrosing colonopathy.