Doppler Activity and Ultrasonographic Detection of Intra-Abdominal Fistulas Are Predictors of Surgery in Crohn's Disease.
Bakground and Aim: Predictors of the need for surgery in sticturing Crohn's disease (SCD) are lacking. Bowel ultrasound (US) is a harmless, noninvasive, and inexpensive diagnostic procedure that has proven to be a valuable tool in the management of Crohn's disease (CD). Our aim was to identify ultrasonographic findings in SCD that may associate with a higher risk of surgery, allowing us to make early choices regarding treatment election in this specific group of patients.


MATERIALS AND METHODS
This was a retrospective, case-control study. Twenty-four patients diagnosed with SCD between 2013 and 2017 with a past history of stricture-related surgery were included and then matched with 46 non-operated controls. Prior US from patients in both groups were analyzed. US features considered for analysis were as follows: bowel wall thickness, degree of parietal vascularization (measured by Doppler activity), prestenotic dilation, involvement of mesenteric fat, and newly detected concomitant fistulas or abscess.


RESULTS
Doppler activity (p < 0.001), enteroenteric fistulas (p = 0.04), enteromesenteric fistulas (p = 0.003), and associated abscess (p = 0.004) were significantly associated with the need for surgery in the short-term period. Multivariate analysis showed strong association of these features with the risk of surgery but failed to reach statistical significance.


CONCLUSION
US features may potentially be used as point-of-care tools to aid clinicians in the assessment of the surgical risk in patients with SCD.
['Rueda García|Jose Luis|JL|', 'Suárez-Ferrer|Cristina|C|', 'Poza Cordón|Joaquín|J|', 'Martín-Arranz|Eduardo|E|', 'Sánchez Azofra|María|M|', 'García Ramírez|Laura|L|', 'Noci|Jesús|J|', 'Martín-Arranz|María Dolores|MD|']
D000005:Abdomen D000328:Adult D016022:Case-Control Studies D003424:Crohn Disease D005260:Female D005402:Fistula D006801:Humans D008297:Male D015999:Multivariate Analysis D012189:Retrospective Studies D012307:Risk Factors D018608:Ultrasonography, Doppler
Surgery Crohn’s disease Inflammatory bowel diseases Ultrasonography