Inflammatory bowel disease: ultrasound may help detect Crohn's disease.

Clinical bottom line (level 4)

  1. Ultrasound scanning of the abdomen may help rule in or rule out Crohn's disease, but requires further validation.
Pera et al: Digestion 1988; 41: 180-184
Expires May 2003

The study

Setting: GI clinic, acute hospital, Italy

181 patients (aged range 17 to 77 years; mean 40, 62% male) with intestinal disease (89 with Crohn's disease, 57 with ulcerative colitis, 35 controls)

Excluded if
  • previous major abdominal surgery
  • palpable mass
  • enterocutaneous fistulas
  • skin lesions typical of inflammatory bowel disease
  • ulcerative colitis or Crohn's disease restricted to the rectum



    • Independent blinded reference standard, applied in ?all patients from a consecutive inappropriate spectrum.
    Reference standard:
    • histology, endoscopy, radiology and clinical findings
    Diagnostic test: ultrasound abdomen. Crohn's disease if:
    • target appearance of bowel (strong echogenic centre with a sonolucent rim > 0.5 cm diameter) +/- stenosis
    • distended fluid-filled loops, luminal narrowing, movement of echogenic particles or stiff loops

    The evidence


    diagnostic test Crohn's disease no Crohn's disease LR+
    (95% CI)    		 post-test probability LR-
    (95% CI)    		 post-test probability
    ultrasound scan positive 75 16 4.9
    (3.1 to 7.6)     		82% 0.19
    (0.12 to 0.31)     		16%
    total 89 92

    Citation

    1. Pera A, Cammarota T, Comino E, et al: ultrasonography in the detection of Crohn's disease and in the differential diagnosis of inflammatory bowel disease. Digestion 1988; 41: 180-184
    Contributor: Chris Ball and Clare Wotton, September 2000
    Reviewer:

    Clinical Question.
    Patient inflammatory bowel disease
    Intervention or Exposure ultrasound scan
    Outcome diagnosis of Crohn's disease