Postsurgical recurrence is common in patients with Crohn's disease who have undergone surgery.
Endoscopy is crucial for the diagnosis of postsurgical recurrence, showing also high prognostic value.
Bowel sonography is accurate for Crohn's disease diagnosis, but its role in postsurgical recurrence detection and grading has been poorly investigated.
Dr Antonio Rispo and colleagues evaluated the diagnostic accuracy of bowel sonography vs endoscopy in the detecting postsurgical recurrence.
The researchers performed endoscopy and bowel sonography in 45 Crohn's disease patients who had undergone previous bowel resection.
|For severe postsurgical recurrence, the sensitivity of bowel sonography was 93%|
|Inflammatory Bowel Diseases|
Endoscopy and bowel sonography were carried out 1 year after surgery.
Diagnosis and grading of postsurgical recurrence was made in accordance with Rutgeerts.
The team considered bowel sonography suggestive for postsurgical recurrence in the presence of bowel wall thickness more than 3 mm.
Also, a receiver operating characteristic curve was constructed.
The researchers used the curve to define the best cutoff value for bowel wall thickness to differentiate mild from severe postsurgical recurrence.
The team observed that 53% of patients with Crohn's disease showed endoscopic evidence of postsurgical recurrence.
Severe endoscopes postsurgical recurrence was present in 66% of patients.
Sensitivity, specificity, and positive and negative predictive values of bowel sonography were 79%, 95%, 95%, and 80%, respectively.
The researchers noted that for severe postsurgical recurrence, the sensitivity of bowel sonography was 93%.
A bowel wall thickness more than 5 mm showed sensitivity, specificity of 94% and 100%, respectively, in differentiating mild from severe postsurgical recurrence.
In addition, the team observed positive and negative predictive values of 100%, and 96%, respectively.
These results are in remarkable agreement with endoscopy.
Dr Rispo‘s team concluded, “Bowel sonography shows good sensitivity and high specificity for the diagnosis of postsurgical recurrence in Crohn's disease.”
“A bowel wall thickness more than 5 mm being strongly indicative of severe endoscopes postsurgical recurrence.”
“Hence, bowel sonography could replace endoscopy for the diagnosis and grading of postsurgical recurrence in patients who comply poorly with the endoscopic examination.”