ROLE OF ULTRASONOGRAPHY IN THE DIAGNOSIS OF POSTSURGICAL RECURRENCE OF CROHNS-DISEASE

Objective: Ultrasonography is a valid tool in the diagnosis of Crohn's disease, but its sensitivity, specificity, and overall accuracy in th e diagnosis of postoperative recurrence are still not well established , The aim of this study was to evaluate the accuracy of ultrasonograph y compared with endoscopy in the diagnosis of postoperative recurrence of Crohn's disease. Methods: Forty-seven patients resected for Crohn' s ileitis were studied by ultrasonography and colonoscopy to detect po ssible recurrence of the disease; 10 patients operated on for cancer o f the right colon were used as controls. Six patients with Crohn's dis ease were excluded from the study because of failure to endoscopically reach the anastomosis; the remaining 41 patients had both ultra-sonog raphy and colonoscopy over a period of 14 days. Sonographic recurrence was defined as the presence of >5 mm thickness of the ileal wall. Res ults: Sensitivity, specificity, and overall accuracy of ultrasonograph y in diagnosis of postoperative recurrence were 81%, 86%, and 83% resp ectively. Positive predictive value was 96% and negative predictive va lue was 57%, Conclusion: This study is the first to assess the role of ultrasonography in comparison with endoscopy in detecting Crohn's dis ease recurrence after surgery. Our data suggest that ultra-sonography should be used first in the case of clinical suspicion of Crohn's dise ase recurrence, reserving ileocolonoscopy for negative or uncertain ca ses. (C) 1998 by Am. Coll. of Gastroenterology.