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Sonographic evaluation of a surgically created pouch

  • Special Section: Crohn Disease
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

This manuscript focuses on a review of the normal and abnormal sonographic appearance of the surgically created pouch as part of an article series on the topic. It includes information regarding sonographic technique, normal anatomy, and commonly encounter diseases and complications.

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References

  1. C. Lu, C. Merrill, A. Medellin, K. Novak, and S. R. Wilson, “Bowel Ultrasound State of the Art: Grayscale and Doppler Ultrasound, Contrast Enhancement, and Elastography in Crohn Disease,” J. Ultrasound Med., vol. 38, no. 2, 2019, https://doi.org/10.1002/jum.14920.

  2. F. Castiglione et al., “Noninvasive Diagnosis of Small Bowel Crohn’s Disease,” Inflamm. Bowel Dis., vol. 19, no. 5, pp. 991–998, Apr. 2013, doi: https://doi.org/10.1097/MIB.0b013e3182802b87.

    Article  PubMed  Google Scholar 

  3. M. L. W. Ziech et al., “Accuracy of abdominal ultrasound and MRI for detection of Crohn disease and ulcerative colitis in children,” Pediatr. Radiol., 2014, doi: https://doi.org/10.1007/s00247-014-3010-4.

    Article  PubMed  Google Scholar 

  4. D. Roccarina et al., “Diagnosis of bowel diseases: The role of imaging and ultrasonography,” World J Gastroenterol, vol. 19, no. 1914, pp. 2144–2153, 2013, doi: https://doi.org/10.3748/wjg.v19.i14.2144.

    Article  PubMed  PubMed Central  Google Scholar 

  5. A. E. Bohte, J. R. Van Werven, S. Bipat, and J. Stoker, “The diagnostic accuracy of US, CT, MRI and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: A meta-analysis,” Eur. Radiol., vol. 21, no. 1, pp. 87–97, 2011, doi: https://doi.org/10.1007/s00330-010-1905-5.

    Article  Google Scholar 

  6. M. Fraquelli et al., “Role of US in detection of Crohn disease: meta-analysis.,” Radiology, vol. 236, no. 1, pp. 95–101, 2005, doi: https://doi.org/10.1148/radiol.2361040799.

    Article  PubMed  Google Scholar 

  7. S. A. Taylor et al., “Diagnostic accuracy of magnetic resonance enterography and small bowel ultrasound for the extent and activity of newly diagnosed and relapsed Crohn’s disease (METRIC): a multicentre trial,” Lancet Gastroenterol. Hepatol., vol. 3, no. 8, pp. 548–558, Aug. 2018, doi: https://doi.org/10.1016/S2468-1253(18)30161-4.

    Article  PubMed  PubMed Central  Google Scholar 

  8. D. Cosgrove et al., “EFSUMB Guidelines and Recommendations on the clinical use of ultrasound elastographypart 2: Clinical applications,” Ultraschall in der Medizin, vol. 34, no. 3. 2013. https://doi.org/10.1055/s-0033-1335375.

  9. C. Frias-Gomes, J. Torres, and C. Palmela, “Intestinal Ultrasound in Inflammatory Bowel Disease: A Valuable and Increasingly Important Tool,” GE Portuguese Journal of Gastroenterology, vol. 29, no. 4. S. Karger AG, pp. 223–239, Jul. 23, 2022. https://doi.org/10.1159/000520212.

  10. O. M. Nardone et al., “The Impact of Intestinal Ultrasound on the Management of Inflammatory Bowel Disease: From Established Facts Toward New Horizons,” Front. Med., vol. 9, no. May, pp. 1–9, 2022, doi: https://doi.org/10.3389/fmed.2022.898092.

    Article  Google Scholar 

  11. J. M. Barlow, A. L. Lightner, S. P. Sheedy, D. H. Bruining, C. O. Menias, and J. G. Fletcher, “J Pouch : Imaging Findings , Sur- gical Variations , Natural History , and Common Complications,” 2018.

  12. Z. S. Ardalan et al., “Accuracy of Gastrointestinal Ultrasound and Calprotectin in the Assessment of Inflammation and its Location in Patients with an Ileoanal Pouch,” J. Crohn’s Colitis, vol. 16, no. 1, pp. 79–90, 2022, doi: https://doi.org/10.1093/ecco-jcc/jjab125.

    Article  Google Scholar 

  13. K. L. Novak et al., “A Simple Ultrasound Score for the Accurate Detection of Inflammatory Activity in Crohnʼs Disease,” Inflamm. Bowel Dis., vol. 0, no. 0, p. 1, 2017, doi: https://doi.org/10.1097/MIB.0000000000001174.

  14. A. Medellin, C. Merrill, and S. R. Wilson, “Role of contrast-enhanced ultrasound in evaluation of the bowel,” Abdom. Radiol., 2017, doi: https://doi.org/10.1007/s00261-017-1399-6.

    Article  Google Scholar 

  15. A. Medellin-Kowalewski, R. Wilkens, A. Wilson, J. Ruan, and S. R. Wilson, “Quantitative contrast-enhanced ultrasound parameters in Crohn disease: Their role in disease activity determination with ultrasound,” Am. J. Roentgenol., vol. 206, no. 1, pp. 64–73, 2016, doi: https://doi.org/10.2214/AJR.15.14506.

    Article  Google Scholar 

  16. T. Ripollés, M. J. Martínez, J. M. Paredes, E. Blanc, L. Flors, and F. Delgado, “Crohn Disease: Correlation of Findings at Contrast-enhanced US with Severity at Endoscopy,” Radiology, vol. 253, no. 1, pp. 241–248, 2009, doi: https://doi.org/10.1148/radiol.2531082269.

    Article  PubMed  Google Scholar 

  17. B. H. Drews et al., “Comparison of sonographically measured bowel wall vascularity, histology, and disease activity in Crohn’s disease.,” Eur. Radiol., vol. 19, no. 6, pp. 1379–86, Jun. 2009, doi: https://doi.org/10.1007/s00330-008-1290-5.

    Article  CAS  PubMed  Google Scholar 

  18. A. Albuquerque and E. Pereira, “Current applications of transperineal ultrasound in gastroenterology,” World J. Radiol., vol. 8, no. 4, p. 370, 2016, doi: https://doi.org/10.4329/wjr.v8.i4.370.

    Article  PubMed  PubMed Central  Google Scholar 

  19. K. P. Dhamanaskar, W. Thurston, and S. R. Wilson, “Transvaginal sonography as an adjunct to endorectal sonography in the staging of rectal cancer in women,” Am. J. Roentgenol., vol. 187, no. 1, pp. 90–98, 2006, doi: https://doi.org/10.2214/AJR.04.1363.

    Article  Google Scholar 

  20. M. J. Kim, “Transrectal ultrasonography of anorectal diseases: Advantages and disadvantages,” Ultrasonography, vol. 34, no. 1, pp. 19–31, Nov. 2014, doi: https://doi.org/10.14366/usg.14051.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Y. Sun, L.-G. Cui, J.-B. Liu, J.-R. Wang, H. Ping, and Z.-W. Chen, “Utility of 360° Real-time Endoanal Sonography for Evaluation of Perianal Fistulas,” J. Ultrasound Med., vol. 37, no. 1, pp. 93–98, Jan. 2018, doi: https://doi.org/10.1002/jum.14307.

    Article  PubMed  Google Scholar 

  22. E. Panel et al., “APPROPRIATE USE CRITERIA ACR Appropriateness Criteria â Anorectal Disease,” J. Am. Coll. Radiol., vol. 18, no. 11, pp. S268–S282, 2021, doi: https://doi.org/10.1016/j.jacr.2021.08.009.

  23. F. Cao et al., “Correlation between Disease Activity and Endorectal Ultrasound Findings of Chronic Radiation Proctitis.,” Ultrasound Med. Biol., vol. 43, no. 10, pp. 2182–2191, Oct. 2017, doi: https://doi.org/10.1016/j.ultrasmedbio.2017.06.025.

    Article  PubMed  Google Scholar 

  24. A. Sharma, P. Yadav, M. Sahu, and A. Verma, “Current imaging techniques for evaluation of fistula in ano: a review,” Egypt. J. Radiol. Nucl. Med., vol. 51, no. 1, 2020, https://doi.org/10.1186/s43055-020-00252-9.

  25. C. Lu, X. Gui, W. Chen, T. Fung, K. Novak, and S. R. Wilson, “Ultrasound Shear Wave Elastography and Contrast Enhancement: Effective Biomarkers in Crohn’s Disease Strictures.,” Inflamm. Bowel Dis., vol. 0, no. 0, pp. 1–10, 2017, https://doi.org/10.1097/MIB.0000000000001020.

  26. D. Ślósarz, E. Poniewierka, K. Neubauer, and R. Kempiński, “Ultrasound elastography in the assessment of the intestinal changes in inflammatory bowel disease—systematic review,” Journal of Clinical Medicine, vol. 10, no. 18. MDPI, Sep. 01, 2021. https://doi.org/10.3390/jcm10184044.

  27. P. P. Tekkis, “A systematic review and meta-analysis comparing adverse events and functional outcomes of different pouch designs after restorative proctocolectomy,” pp. 664–675, 2018, https://doi.org/10.1111/codi.14104.

  28. K. P. Quinn, A. L. Lightner, W. A. Faubion, and L. E. Raffals, “A Comprehensive Approach to Pouch Disorders,” vol. 25, no. 3, pp. 460–471, 2019, https://doi.org/10.1093/ibd/izy267.

  29. M. Prudhomme, R. R. Dozois, G. Godlewski, S. Mathison, and P. Fabbro-Peray, “Anal canal strictures after ileal pouch-anal anastomosis.,” Dis. Colon Rectum, vol. 46, no. 1, pp. 20–3, Jan. 2003, doi: https://doi.org/10.1007/s10350-004-6491-7.

    Article  CAS  PubMed  Google Scholar 

  30. B. Shen et al., “Endoscopic and histologic evaluation together with symptom assessment are required to diagnose pouchitis,” Gastroenterology, vol. 121, no. 2, pp. 261–267, 2001, doi: https://doi.org/10.1053/gast.2001.26290.

    Article  CAS  PubMed  Google Scholar 

  31. F. Khan and B. Shen, “Complications Related to J-Pouch Surgery,” vol. 14, no. 10, pp. 571–576, 2018.

  32. A. L. Lightner, J. H. Pemberton, and E. J. Loftus, “Crohn’s Disease of the Ileoanal Pouch.,” Inflamm. Bowel Dis., vol. 22, no. 6, pp. 1502–8, Jun. 2016, doi: https://doi.org/10.1097/MIB.0000000000000712.

    Article  PubMed  Google Scholar 

  33. A. L. Lightner, J. G. Fletcher, J. H. Pemberton, K. L. Mathis, L. E. Raffals, and T. Smyrk, “Crohn’s Disease of the Pouch: A True Diagnosis or an Oversubscribed Diagnosis of Exclusion?,” Dis. Colon Rectum, vol. 60, no. 11, pp. 1201–1208, Nov. 2017, doi: https://doi.org/10.1097/DCR.0000000000000918.

    Article  PubMed  Google Scholar 

  34. E. L. Barnes, B. Kochar, and H. R. Jessup, “The Incidence and Definition of Crohn ’ s Disease of the Pouch : A Systematic Review and Meta-analysis,” vol. 25, no. 9, pp. 1474–1480, 2019, https://doi.org/10.1093/ibd/izz005.

  35. B. Shen et al., “Diagnosis and classification of ileal pouch disorders: consensus guidelines from the International Ileal Pouch Consortium,” The Lancet Gastroenterology and Hepatology, vol. 6, no. 10. Elsevier Ltd, pp. 826–849, Oct. 01, 2021. https://doi.org/10.1016/S2468-1253(21)00101-1.

  36. F. Berton, G. Gola, and S. R. Wilson, “Perspective on the role of transrectal and transvaginal sonography of tumors of the rectum and anal canal,” Am. J. Roentgenol., vol. 190, no. 6, pp. 1495–1504, 2008, doi: https://doi.org/10.2214/AJR.07.3188.

    Article  Google Scholar 

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Authors

Contributions

SW and AM (authors) contributed to the manuscript, material selection and preparation. The first draft of the manuscript was written by AM and SW commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Alexandra Medellin.

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Conflict of interest

Alexandra Medellin have received book royalties from Elsevier. Stephanie R. Wilson: Advisory Board, Definity. Lantheus Medical Imaging Speakers Bureau, Philips. Equipment support: Philips, Siemens, Samsung.

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Medellin, A., Wilson, S. Sonographic evaluation of a surgically created pouch. Abdom Radiol 48, 2986–2999 (2023). https://doi.org/10.1007/s00261-023-03941-x

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