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Journal of Ultrasound

, Volume 19, Issue 3, pp 231–237 | Cite as

Feasibility of CEUS and strain elastography in one case of ileum Crohn stricture and literature review

  • Andrea Giannetti
  • Marco Biscontri
  • Marco Matergi
  • Michela Stumpo
  • Chiara Minacci
Case Report

Abstract

Contrast-enhanced ultrasonography (CEUS) and strain elastography (SE) are diagnostic imaging methods, which are still not routinely used in the clinical management of inflammatory bowel diseases. However, there are studies in the literature reporting on the use of both CEUS and SE in patients with bowel obstruction due to Crohn's disease, documenting the usefulness of these two methods in the differentiation between inflammation and fibrosis affecting the bowel wall. The aim of this case report is to evaluate the usefulness of CEUS and SE performed in a patient with Crohn's disease, who was admitted to hospital with bowel obstruction due to terminal ileal stricture and submitted to ileocecal resection. CEUS and SE identified and to some extent also characterized the inflammatory and fibrotic processes affecting the bowel wall. Macroscopic and microscopic examinations of the surgical specimen confirmed the presence of inflammatory phenomena (exudates, ulcers, and fistulas) and fibrosis as suggested by ultrasound (US) imaging methods.

Keywords

Bowel Wall Ileocecal Valve Strain Elastography Thickened Bowel Wall Muscular Hypertrophy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Sommario

L' ecografia con mezzo di contrasto (CEUS) e la elastografia strain (SE) sono metodiche recenti, ancora poco utilizzate nel management clinico delle malattie infiammatorie croniche intestinali. Riguardo alle stenosi intestinali nel morbo di Crohn, in Letteratura sono pubblicati studi sia con la CEUS che con la SE che hanno documentato l'utilità delle due metodiche nel differenziare la natura flogistica o fibrotica del tratto patologico. Scopo di questo report è di valutare l'utilità delle due metodiche in un paziente affetto da morbo di Crohn, ricoverato per occlusione intestinale da stenosi dell'ultima ansa ileale ed operato di resezione dell'ileo terminale e del ceco. La CEUS e la Elastografia Strain hanno permesso la documentazione ed in un certo grado anche una misura dei processi flogistici e fibrotici a carico della parete intestinale affetta. L'esame macroscopico e microscopico del tratto resecato ha consentito di confermare la presenza dei fenomeni flogistici e fibrotici come ipotizzato con le due metodiche ecografiche.

Notes

Compliance with ethical standards

Conflict of interest

Authors have no conflict of interest to declare related to this study.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki declaration of 1975, as revised in 2000. The patient provided written informed consent to enrolment in the study and to the publication of information that could potentially lead to his identification.

Human and animal studies

The study described in this article does not involve the use of animal subjects.

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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2016

Authors and Affiliations

  1. 1.Gastroenterology UnitMisericordia HospitalGrossetoItaly
  2. 2.Pathology DepartmentMisericordia HospitalGrossetoItaly

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