Abstract
Background
Screening for inflammatory small bowel disease has hereto relied on barium examination, usually performed after duodenal intubation. A noninvasive technique for imaging of the small bowel in such patients would be preferable.
Methods
A total of 59 patients were included in the study. A small bowel barium examination (SBE) was performed after duodenal intubation using a barium and air double-contrast technique. Ultrasound (US) of the right lower quadrant was performed with a 3.5- or 5-MHz transducer. The patients fasted overnight.
Results
In 37 of 39 patients with a normal SBE, US was also normal. In 20 patients, SBE showed lesions compatible with Crohn disease and in 18 of these the US study showed thickening of the bowel wall. One of these patients later tested positive for Yersinia enterocolitica. There were two false-positive and two false-negative US examinations.
For detection of inflammatory disease of the small bowel, US was calculated to have a sensitivity of 0.95, specificity of 0.93, accuracy of 0.93, predictive value of a positive test was 0.90, and a predictive value of a negative test was 0.95.
Conclusions
US, therefore, seems to be a reliable method in the workup of patients suspected of having inflammatory small bowel disease. Thereby, US probably can select patients for SBE.
Similar content being viewed by others
References
Maglinte DDT, Lappas JC, Kelvin FM, Rex D, Chernish SM. Small bowel radiography: how, when, and why? Radiology 1987;163:279–305
Matsumoto T, Iida M, Sakai T, Kimura Y, Fujishima M. Yersinia terminal ileitis: sonographic findings in 8 patients. AJR 1991;156:965–967
Odegaard S, Kimmey MB. Location of the muscularis mucosae in high frequency gastrointestinal ultrasound images. Eur J Ultrasound 1994;1:39–50
Yeh H-C, Rabinowitz JG. Granulomatous enterocolitis: findings by ultrasonography and computed tomography. Radiology 1983;149:253–259
Puylaert JBC, et al. Crohn's disease of the ileocecal region: US visualization of the appendix. Radiology 1988;166:741–743
Khaw KT, Yeoman LJ, Saverymuttu SH, Cook MG, Joseph AEA. Ultrasonic patterns in inflammatory bowel disease. Clin Radiol 1991;43:171–175
Khaw KT, Saverymuttu SH, Joseph AEA. Correlation of 111Indium WBC scintigraphy with ultrasound in the detection and assessment of inflammatory bowel disease. Clin Radiol 1990;42:410–413
Kimmey MB, et al. Diagnosis of inflammatory bowel disease with ultrasound: an in vitro study. Invest Radiol 1990;25:1085–1090
Martin DF. Ultrasound of the alimentary tract. Imaging 1992;4:117–127
Schwerk WB, Beckh K, Raith M. A prospective evaluation of high resolution sonography in the diagnosis of inflammatory bowel disease. Gastroenterol Hepatol 1992;4:173–182
Pera A, Cammarota T, Comino E, Caldera D, Ponti V, Astegiano M, Barletti C, Rocca R, Cosimato M, Bertolusso L. Ultrasonography in the detection of Crohn's disease and in the differential diagnosis of inflammatory bowel disease. Digestion 1988;41:180–184
Jenss H, Klott AJ, Malchuw H. Sonographie Darstellung von Fisteln und Abszessen beim Morbus Crohn. Leber, Magen, Darm 1980;10:317–320
Puylaert JBCM, Lalisang RI, van der Werf SDJ, et al. Campylobacter ileocolitis mimicing acute appendicitis: differentiation with graded compression ultrasound. Radiology 1988;166:737–740
Goerg C, Schwerk WB, Goerg K. Gastrointestinal lymphoma: sonographic findings in 54 patients. AJR 1990;155:795–798
DiCandio G, et al. Sonographic detection of postsurgical recurrence of Crohn disease. AJR 1986;146:523–526
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Solvig, J., Ekberg, O., Lindgren, S. et al. Ultrasound examination of the small bowel: comparison with enteroclysis in patients with Crohn disease. Abdom Imaging 20, 323–326 (1995). https://doi.org/10.1007/BF00203364
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00203364