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The value of ultrasound as a primary imaging modality in detection of ileocecal Crohn's disease | ||
| KUFA MEDICAL JOURNAL | ||
| Article 1, Volume 14, Issue 2, 2011, Pages 165-173 | ||
| Authors | ||
| ; Dr. Eaman Muhsin Ali | ||
| Abstract | ||
| Ultrasound (US) is used as an initial screening procedure in all patients with abdominal symptoms. The purpose of this study is to assess the use of this policy in the detection of ileocecal Crohn's disease. We retrospectively studied all patients with a new diagnosis of ileocecal Crohn's disease over the period from 2000-2006. The final diagnosis was based on clinical follow-up and pathological, surgical, US, and other radiological findings. We noted who referred the patient to the radiology department, what the initial clinical diagnosis was, and what the first imaging study was. US diagnosis was determined from the initial US report and US findings were registered from the images. There were a total of 47 patients (20 male, 27 female) with a mean age of 30 years and a median age of 27 years (range 17-70 years). In all patients the initial imaging study was an abdominal US. Using US, a confident diagnosis of ileocecal Crohn's disease was made in 35 of the 47 patients, Crohn's disease was suggested among the differential diagnosis in 10, and an incorrect diagnosis was made in 2 patients. In 28 of 47 patients, the referring physician did not consider Crohn's disease when requesting the initial US examination. In eight patients with appendicitis-like symptoms, the US findings strongly influenced the decision to refrain from operation at that time. US, when used as a low-threshold diagnostic procedure, is a reliable and noninvasive means for making an early diagnosis of ileocecal Crohn's disease in patients who present with atypical symptoms. It may prevent both unnecessary therapeutic delay as well as unnecessary surgery. | ||
| Keywords | ||
| ultrasound; Crohn; appendicitis | ||
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