ENDOSONOGRAPHIC FEATURES OF THE LOWER PELVIC REGION IN CROHNS-DISEASE

Anorectal complications in long-term Crohn's disease are frequent and evaluation of inflammatory changes in the lower pelvic region is diffi cult. Abnormalities are fistulas and abscesses which can be demonstrat ed rapidly and easily by endosonographic measures. Further topographic al localization of the abnormalities is possible. Over a period of 2 y r, 55 patients with anorectal complications were examined. Using endos onography, 46 fistulas were found in 36 patients. Forty patients prese nted inflammatory changes. Abscesses were demonstrated in four cases. Our findings were verified by surgery, fistulography, and correlation with clinical course of illness. Limiting factor of the examination pr ocedure proved to be painful and strictures in male patients, whereas in female patients the alternative of performing the examination via v agina was given. Our results demonstrate that endosonography is an exc ellent screening method for detecting and evaluating fistulas and absc esses in Crohn patients. Omitting radiation exposure is a further adva ntage of endosonography.