Prospective evaluation of transabdominal bowel sonography in the diagnosisof intestinal obstruction in Crohn's disease: Comparison with plain abdominal film and small bowel enteroclysis

Transabdominal ultrasonography is a noninvasive, radiation-free method that is well tolerated by patients with acute abdominal symptoms. The aim of th is study was to investigate the validity of transabdominal ultrasonography, compared with plain abdominal film and small bowel enteroclysis, in the di agnosis of small bowel obstruction in patients with Crohn's disease (CD). F orty-four patients with CD ileitis or ileocolitis and acute obstructive sym ptoms who received ultrasonography and plain abdominal film at hospital adm ission were evaluated by small bowel enema before dismissal or surgery and were considered for statistical analysis. Small bowel obstruction was diagn osed by ultrasonography in 23 of 44 patients (52%), by plain abdominal film in 26 of 44 patients (59%), and by small bowel enema in 28 of 44 patients (64%); the diagnostic accuracy of plain abdominal film and ultrasonography compared with small bowel enema was 73% and 89%, respectively. Ultrasonogra phy proved to be highly specific (100%) with no false positive results. Sur gery performed in 25 of 44 patients for symptoms refractory to medical trea tment confirmed the high diagnostic value of ultrasonography. The result of this study indicates that transabdominal ultrasonography is accurate and h ighly specific in the diagnosis of small bowel obstruction and can be consi dered a valuable first choice examination in CD patients with obstructive s ymptoms.