Value of computed tomography in the detection of complications of Crohn's disease

Abstract

Abdominal and pelvic computed tomography (CT) scans were performed on 17 patients with suspected complications of Crohn's disease. CT was superior to conventional barium studies and colonoscopy in demonstrating mural, serosal, and mesenteric pathology such as bowel wall thickening (100%), abscess (59%) and phlegmon (6%) formation, and fibro-fatty proliferation of the mesentery (41%). While not advocated as the primary means of evaluating Crohn's disease, CT can provide information vital to the management of complications of this disease.

Prevalence and clinical significance of sonographic evidence of mesenteric fat alterations in Crohnʼs disease

“…Using other cross-section imaging methods, such as CT or magnetic resonance imaging (MRI), mesenteric fat hypertrophy has been described as a change in density of the tissue surrounding the bowel walls. 7,12,18,19 However, unlike some of these studies, we have not reported the US degree of the density of mesenteric fat or the quantification of the intraabdominal fat accumulation, since US is less objective and lacks the panoramic view of CT and MRI. Therefore, we assessed only the absence or presence of this condition, considering it present when a Ͼ5-6 mm hyperechoic halo around the thickened bowel walls was visible.…”

“…Using different imaging methods, such as CT, the presence of increased fat density has been assessed in 25%-41% of CD patients. 7,18,19 Moreover, surgical series 2 identified fat wrapping in 70% of bowel resections. Undoubtedly, besides the methods used to assess mesenteric fat hypertrophy, the prevalence of this condition in CD also depends on patient selection.…”

Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead ‘Optimised Monitoring' Recommendations

“…Abdominal MDCT is the modality of choice for an acutely ill CD patient presenting in the emergency room. The MDCT findings correlate well with disease activity (level B) [60,61,62]. Contrast-enhanced CT of the abdomen/pelvis or US are useful in acutely ill patients to rule out complications such as intra-abdominal abscesses (level B) [61,68,115,116].…”

“…CT scans are useful in patients with fulminant symptoms to detect bowel obstruction, perforation, or toxic colon distension (level B) [60,61,62]. Abdominal MDCT is the modality of choice for an acutely ill CD patient presenting in the emergency room.…”

“…For an acutely ill patient who is admitted to the emergency unit with suspected CD, abdominal multidetector CT (MDCT) scanning is the recommended modality of choice (level B) [60,61,62]. …”