SONOGRAPHY OF INFLAMMATORY BOWEL-DISEASE - FINDINGS AND VALUE IN DIFFERENTIAL-DIAGNOSIS

OBJECTIVE. Inflammatory bowel diseases produce segmental or diffuse mu ral thickening of the intestine that can be detected and evaluated by using sonography. The purpose of this study was to evaluate the sonogr aphic findings and determine their diagnostic value in patients with i nflammatory bowel diseases. MATERIALS AND METHODS. We reviewed sonogra ms of 81 patients with inflammatory bowel diseases. The findings were compared with those of barium study, colonoscopy, and surgery, Forty-f ive patients had tuberculous enterocolitis, 13 had ulcerative colitis, eight had Crohn's disease, five had ischemic colitis, two had Behcet' s syndrome, and eight had unspecified colitis. Diagnosis was based on surgical and pathologic findings in 23; results of barium study and en doscopic biopsy in 20; and results of barium study, colonoscopic findi ngs, and clinical findings in 38. RESULTS. Seventy-two patients (89%) had sonograms that showed segmental or diffuse mural thickening and a paucity of luminal content in the involved bowel. Involved areas were the ileocecal region in the cases of tuberculous enterocolitis and Beh cet's syndrome, the left side of the colon in ulcerative colitis, and the colon and terminal part of the ileum in Crohn's disease, In ischem ic colitis, the distribution of involved bowel was nonspecific. Sonogr aphic findings correlated well with the findings of barium enema or co lonoscopy in terms of the involved segments of the bowel. Mesenteric l ymphadenitis, omental thickening, and ascites were frequently observed in cases of tuberculous enterocolitis. CONCLUSION. Sonographic eviden ce of mural thickening of the bowel with a paucity of luminal content may be helpful in the detection of inflammatory bowel diseases. Howeve r, the findings are nonspecific, and the differential diagnosis must b e related to the specific segment of the bowel involved.