Radiographic underestimation of small bowel stricturing Crohn's disease: A comparison with surgical findings

Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in crohnʼs disease: A prospective comparative study versus intraoperative findings

“…20,21 Surgery remains an important component of treatment of CD and an accurate preoperative assessment of CD lesions and associated complications is required to plan the surgical approach and intervention. [22][23][24] Such preoperative assessment is even more important when using a laparoscopic approach that may limit the surgeons manual search for subtle lesions of the intestine. 23 Four studies 8,9,12,18 have compared TUS and CT preoperative findings with operative findings.…”

Crohn’s Disease Activity Index and Vienna Classification – Is It Worthwhile to Calculate before Surgery?

“…As mentioned previously, the number of strictures is often underestimated by radiographic as compared to surgical findings in CD patients [13] . Peristalsis and widening as well as distension or adhesions of the intestinal tract may mislead the examiner, who may furthermore focus on the most dominant lesion, causing him to direct less attention towards other findings [13] .…”

“…Surgical therapy prior to the VC and CDAI staging may have biased our results, since the specificity of diagnostic techniques preoperatively may be altered [13] , and anastomoses may mature into restenoses. However, comparison of the CDAI's of patients with or without preceding surgery showed no statistical difference.…”

“…Peristalsis and widening as well as distension or adhesions of the intestinal tract may mislead the examiner, who may furthermore focus on the most dominant lesion, causing him to direct less attention towards other findings [13] . Although in our study diagnoses relied on combined techniques including endoscopy, radiographic examinations, CT, MRT and ultrasound, we frequently (54.4%) found that while only a single site was diagnosed preoperatively, more sites actually required surgical therapy.…”

“…It may be misleading to apply these two indices to decision making involving patient's awaiting surgery. In the preoperative environment, clinical parameters may be altered by previous drug treatment [10][11][12] , changes in the disease pattern may occur [9] , and diagnostic findings may underestimate the true extent of the disease [13] . Therefore, the aim of the present study is to analyze the accuracy of both scores in predicting the intra-operative extent of the disease, the amount and technique of surgical therapy required, and early postoperative outcome.…”