5,218 results match your criteria Imaging in Crohn Disease


Outcomes of Pediatric Fistulising Perianal Crohn's Disease.

Turk J Gastroenterol 2021 Mar;32(3):240-247

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Marmara University School of Medicine, Istanbul, Turkey.

Background: Perianal disease is reported more widely in pediatric Crohn patients than in the past, and has been stated as an independent modifier of the disease behavior. In this study, we aimed to analyze the clinical characteristics and outcomes of fistulising perianal Crohn's disease (fpCD) in the pediatric age group.

Methods: A total number of 149 children with an established diagnosis of inflammatory bowel disease who have been diagnosed before 18 years of age and followed in our tertiary center were revised. Read More

View Article and Full-Text PDF

Diagnosis of postoperative recurrence of Crohn disease with MR-enterography: Value of diffusion-weighted imaging.

Diagn Interv Imaging 2021 Jun 18. Epub 2021 Jun 18.

Department of Radiology, Reims University Hospital and CRESTIC, URCA, 51092 Reims, France. Electronic address:

Purpose: To compare the diagnostic capabilities of MR enterography (MRE) using contrast-enhanced (CE) sequences with those of MRE using diffusion-weighted (DW) imaging for the diagnosis of postoperative recurrence at the neo-terminal ileum and/or anastomosis after ileocolonic resection in patients with Crohn disease (CD), and to clarify the role of additional DW imaging to CE-MRE in this context.

Material And Methods: Forty patients who underwent ileal resection for CD, and both endoscopy and MRE within the first year after surgery were included. There were 21 men and 19 women, with a mean age of 38 years±12 (SD) years (range: 18-67 years). Read More

View Article and Full-Text PDF

Development and Validation of a Pediatric MRI-Based Perianal Crohn Disease (PEMPAC) Index-A Report from the ImageKids Study.

Inflamm Bowel Dis 2021 Jun 21. Epub 2021 Jun 21.

Radiology Department, Shaare Zedek Medical Center, Jerusalem, Israel.

Background: As part of the prospective multicenter ImageKids study, we aimed to develop and validate the pediatric MRI-based perianal Crohn disease (PEMPAC) index.

Methods: Children with Crohn disease with any clinical perianal findings underwent pelvic magnetic resonance imaging at 21 sites globally. The site radiologist and 2 central radiologists provided a radiologist global assessment (RGA) on a 100 mm visual analog scale and scored the items selected by a Delphi group of 35 international radiologists and a review of the literature. Read More

View Article and Full-Text PDF

Intestinal hypoperfusion in patients with Crohn's disease revealed by intraoperative indocyanine green fluorescence imaging.

Ann Med Surg (Lond) 2021 Jun 24;66:102402. Epub 2021 May 24.

Department of Digestive Surgery and Transplantation, Institute of Health Biosciences, The University of Tokushima, Kuramoto 3-18-15, Tokushima, 770-8503, Japan.

Background: Anastomotic leakage has been reported as an independent risk factor for surgical recurrence at the anastomotic site in patients with Crohn's disease. An inadequate blood supply may contribute to this leakage. Real-time indocyanine green angiography has been useful for confirming vascular perfusion of the intestines. Read More

View Article and Full-Text PDF

Indications and Limitations Associated with the Patency Capsule Prior to Capsule Endoscopy.

Intern Med 2021 Jun 12. Epub 2021 Jun 12.

Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan.

The retention of the capsule used during small bowel capsule endoscopy (SBCE) is a serious complication that can occur in patients with known or suspected small bowel stenosis, and a prior evaluation of the patency of the gastrointestinal (GI) tract is therefore essential. Patency capsule (PC) is a non-diagnostic capsule the same size as the diagnostic SBCE. To date, there are no clear guidelines regarding the contraindications for undergoing a PC evaluation prior to SBCE. Read More

View Article and Full-Text PDF

Agreement between real-time elastography and delayed enhancement magnetic resonance enterography on quantifying bowel wall fibrosis in Crohn's disease.

Dig Liver Dis 2021 Jun 8. Epub 2021 Jun 8.

Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Via F. Sforza 35, Milan 20122, Italy. Electronic address:

Background: the assessment of fibrosis in Crohn's disease (CD) bowel lesions helps to guide therapeutic decisions. Real-time elastography (RTE) and delayed-enhancement magnetic resonance enterography (DE-MRE) have demonstrated good accuracy in quantifying CD-related ileal fibrosis as compared with histological examination. To date no study has compared DE-MRE and RTE. Read More

View Article and Full-Text PDF

Endoscopic Ultrasound-Guided Transrectal Drainage of Perirectal Abscess in a Patient with Crohn Disease.

Am J Case Rep 2021 Jun 8;22:e930698. Epub 2021 Jun 8.

Department of Gastroenterology, Deaconess Gateway Hospital, Evansville, IN, USA.

BACKGROUND Crohn disease (CD) is an idiopathic chronic inflammatory disease that can present in the perianal area as perianal CD (pCD), which can present as fistulizing or non-fistulizing. Perirectal abscesses are common complications that are strongly associated with fistula formation. Draining an abscess and not treating the associated fistula leads to a high risk of disease recurrence. Read More

View Article and Full-Text PDF

Chronic intentional chicken bone ingestion mimicking inflammatory bowel disease.

BMJ Case Rep 2021 Jun 4;14(6). Epub 2021 Jun 4.

Internal Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA.

Ingestion of food by-products, such as peach pits, chicken bones and fish bones, may lead to intestinal complications. The ingestion of the foreign body is often acute and non-intentional. Acute and life-threatening complications include intestinal perforation or obstruction. Read More

View Article and Full-Text PDF

The Development of Extra-Articular Manifestations in Children With Enthesitis-Related Arthritis: Natural Course or Different Disease Entity?

Front Med (Lausanne) 2021 13;8:667305. Epub 2021 May 13.

Rheumatology Unit, Meyer Children Hospital of Florence, University of Florence, Florence, Italy.

Enthesitis-related Arthritis (ERA) is a specific category of juvenile idiopathic arthritis (JIA) characterized by axial and/or peripheral arthritis, and enthesitis, although other different extra-articular manifestations may encompass its clinical spectrum. In order to examine if ERA-JIA with extra-articular involvement may represent a different entity from ERA without extra-articular involvement, we performed a retrospective, observational, monocentric study, in a cohort of ERA patients followed between 2001 and September 2020 at the Pediatric Rheumatology Unit of Meyer Children Hospital of Florence. We analyzed the demographic, clinical, laboratory and imaging data at the disease onset, as well as after 3, 6, and 12 months follow up. Read More

View Article and Full-Text PDF

Crohn's-like Enteritis in X-Linked Agammaglobulinemia: A Case Series and Systematic Review.

J Allergy Clin Immunol Pract 2021 May 21. Epub 2021 May 21.

Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.

Background: X-linked agammaglobulinemia (XLA) is an inherited primary immunodeficiency that usually manifests clinically with recurrent sinopulmonary infections. Gastrointestinal manifestations are mostly driven by acute infections and disturbed mucosal immunity, but there is a notable prevalence of inflammatory bowel disease (IBD). Differentiating between XLA-associated enteritis, which can originate from recurrent infections, and IBD can be diagnostically and therapeutically challenging. Read More

View Article and Full-Text PDF

Do Forgotten Symptoms Need Treatment?

Authors:
Amnon Sonnenberg

Am J Gastroenterol 2021 04;116(4):841-842

1The Portland VA Medical Center, Portland, Oregon; 2Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon.

View Article and Full-Text PDF

Contrast-enhanced ultrasound of the pediatric bowel.

Pediatr Radiol 2021 May 12. Epub 2021 May 12.

Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.

Contrast-enhanced ultrasound (CEUS) has emerged as a valuable modality for bowel imaging in adults and children. CEUS enables visualization of the perfusion of the bowel wall and of the associated mesentery in healthy and disease states. In addition, CEUS images can be used to make quantitative measurements of contrast kinetics, allowing for objective assessment of bowel wall enhancement. Read More

View Article and Full-Text PDF

Point-of-Care Ultrasound Diagnosis of a Crohn's Disease-Related Intraabdominal Abscess in the Emergency Department.

Cureus 2021 Apr 4;13(4):e14290. Epub 2021 Apr 4.

Emergency Medicine, Hospital Corporation of America (HCA) Healthcare/University of South Florida Morsani College of Medicine Graduate Medical Education (GME) Consortium, Brandon Regional Hospital, Brandon, USA.

The emergency department (ED) diagnosis of Crohn's disease (CD)-associated complications is typically established with abdominopelvic computed tomography imaging. Ultrasonography has been suggested as an effective alternative modality for diagnosing several CD complications, including intraabdominal abscesses. We report the identification of a CD-related intraabdominal abscess by emergency physician (EP)-performed point-of-care ultrasound (POCUS). Read More

View Article and Full-Text PDF

International consensus to standardise histopathological scoring for small bowel strictures in Crohn's disease.

Gut 2021 May 5. Epub 2021 May 5.

Department of Inflammation and Immunity, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Objective: Effective medical therapy and validated trial outcomes are lacking for small bowel Crohn's disease (CD) strictures. Histopathology of surgically resected specimens is the gold standard for correlation with imaging techniques. However, no validated histopathological scoring systems are currently available for small bowel stricturing disease. Read More

View Article and Full-Text PDF

An Overview of Tools to Score Severity in Pediatric Inflammatory Bowel Disease.

Front Pediatr 2021 12;9:615216. Epub 2021 Apr 12.

Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand.

The management of IBD entails the use of various treatments (nutrition, medications, and surgery) in order to induce and maintain remission. The assessment of IBD disease activity is based on a combination of symptoms, clinical findings, imaging, and endoscopic procedures. As in any disease, reliable assessment of disease activity or severity is required in order to plan relevant follow-up, decide on appropriate investigations, determine the best treatment option and subsequently assess response to treatment. Read More

View Article and Full-Text PDF

Infliximab-induced seizures in a patient with Crohn's disease: a case report.

BMC Gastroenterol 2021 Apr 27;21(1):193. Epub 2021 Apr 27.

Center of Clinical Evaluation, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Hangzhou, 310006, Zhejiang, China.

Background: Infliximab-induced seizures in patients with Crohn's disease are extremely rare and the mechanism of infliximab-induced seizures is unclear.

Case Presentation: A 60-year-old woman with Crohn's disease experienced infliximab-induced seizures, diagnosed on normal magnetic resonance imaging of the brain. Moreover, the rechallenge with infliximab was positive. Read More

View Article and Full-Text PDF

Patient-Friendly Summary of the ACR Appropriateness Criteria: Crohn Disease.

J Am Coll Radiol 2021 Apr 20. Epub 2021 Apr 20.

Thoracic and Abdominal Imaging, University of Massachusetts Medical Center, Worcester, Massachusetts. Electronic address:

View Article and Full-Text PDF

Crohn's disease with infliximab treatment complicated by rapidly progressing colorectal cancer: A case report.

World J Gastrointest Oncol 2021 Apr;13(4):305-311

Department of General Surgery, Peking University First Hospital, Beijing 100034, China.

Background: Crohn's disease (CD) causes a range of digestive symptoms including recurrent diarrhea, abdominalgia, and flatulence, and severely impacts the quality of life of patients. Infliximab, a monoclonal antibody against tumor necrosis factor alpha, has recently been promoted as a therapeutic treatment for CD, but its safety margins remain uncertain. We report a case of rapidly progressive colorectal cancer that was diagnosed in a patient with CD who had previously been treated with infliximab. Read More

View Article and Full-Text PDF

Increased Fecal Bile Acid Excretion in a Significant Subset of Patients with Other Inflammatory Diarrheal Diseases.

Dig Dis Sci 2021 Apr 22. Epub 2021 Apr 22.

Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. S.W. Charlton Bldg., Rm. 8-110, Rochester, MN, 55905, USA.

Background: Increased fecal bile acid excretion (IBAX) occurs in a third of patients with functional diarrhea.

Aims: To assess the prevalence of IBAX in benign inflammatory intestinal and colonic diseases presenting with chronic diarrhea.

Methods: All patients with known inflammatory diseases or resections who underwent 48 h fecal fat and BA testing for chronic diarrhea at a single center were included. Read More

View Article and Full-Text PDF

Not all nodules with PET hypermetabolic activity are malignant: a case of lung granuloma in ulcerative colitis.

BMJ Case Rep 2021 Apr 12;14(4). Epub 2021 Apr 12.

Pulmonary and Critical Care Medicine, Ozarks Medical Center, West Plains, Missouri, USA

View Article and Full-Text PDF

Can Conventional and Diffusion-Weighted MR Enterography Biomarkers Differentiate Inflammatory from Fibrotic Strictures in Crohn's Disease?

Medicina (Kaunas) 2021 Mar 15;57(3). Epub 2021 Mar 15.

Department of Medical Surgical Sciences and Advanced Technologies "G.F. Ingrassia"-Radiology I Unit, University Hospital Policlinico "G. Rodolico-San Marco", Via Santa Sofia, 78-95123 Catania, Italy.

To retrospectively assess the value of magnetic resonance enterography (MRE) parameters derived from conventional and diffusion weighted imaging (DWI) sequences to differentiate fibrotic strictures from inflammatory ones in adult patients with Crohn's disease (CD), using surgical specimens as the histopathological reference standard. : Twenty-three patients with CD who had undergone surgical resection of ileal strictures with full-thickness histopathologic analysis within 3 months from preoperative MRE were included. Two radiologists blinded to histopathology in consensus evaluated the following biomarkers on MRE images matched to resected pathological specimens: T1 ratio, T2 ratio, enhancement pattern, mural thickness, pre-stenotic luminal diameter, and apparent diffusion coefficient (ADC). Read More

View Article and Full-Text PDF

The Use of Readily Available Longitudinal Data to Predict the Likelihood of Surgery in Crohn Disease.

Inflamm Bowel Dis 2021 Mar 26. Epub 2021 Mar 26.

Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Background: Although imaging, endoscopy, and inflammatory biomarkers are associated with future Crohn disease (CD) outcomes, common laboratory studies may also provide prognostic opportunities. We evaluated machine learning models incorporating routinely collected laboratory studies to predict surgical outcomes in U.S. Read More

View Article and Full-Text PDF

Risk factors for SARS-CoV-2 infection and course of COVID-19 disease in patients with IBD in the Veterans Affair Healthcare System.

Gut 2021 Mar 22. Epub 2021 Mar 22.

Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Objective: Our aim was to explore the risk of infection with all classes of inflammatory bowel disease (IBD) medications and the impact of these medications on the disease course in a nationwide cohort of patients with IBD.

Design: This was a retrospective national cohort study of patients with IBD in the Veterans Affairs Healthcare System. We categorised IBD medication use immediately prior to the COVID-19 pandemic and used survival analysis methods to study associations with SARS-CoV-2 infection, as well as a combined secondary outcome of COVID-19 hospitalisation or COVID-19-related mortality. Read More

View Article and Full-Text PDF

Management of Crohn's disease in an immunosuppressed COVID-19-positive patient: safety-driven prioritisation of nutritional therapy as a bridge to restarting immunosuppression.

BMJ Case Rep 2021 Mar 22;14(3). Epub 2021 Mar 22.

Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Active inflammatory bowel disease (IBD), combined immunosuppression and corticosteroid therapy have all been identified as risk factors for a poor outcome in COVID-19 infection. The management of patients with both COVID-19 infection and active IBD is therefore complex. We present the case of a 31-year-old patient with Crohn's disease, on dual immunosuppression with infliximab and mercaptopurine presenting with inflammatory small bowel obstruction and COVID-19 infection. Read More

View Article and Full-Text PDF

Routine abdominal magnetic resonance imaging can determine psoas muscle area in paediatric Crohn's disease and correlates with bioelectrical impedance spectroscopy measures of lean mass.

Clin Nutr ESPEN 2021 04 13;42:233-238. Epub 2021 Feb 13.

Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK. Electronic address:

Background: Paediatric Crohn's disease (CD) has been associated with undernutrition. Accurate and accessible measures of body composition would provide data to personalise nutritional therapy. We assessed feasibility of MRI-derived measures of psoas cross-sectional area (PCSA) in paediatric CD and correlated with anthropometric and bioelectrical impedance spectroscopy (BIS) measures. Read More

View Article and Full-Text PDF

Editorial: use of intestinal ultrasound in the scoring of Crohn's disease activity in clinical trials-is it ready for prime time yet?

Aliment Pharmacol Ther 2021 04;53(8):946-947

Division of Gastroenterology and Inflammatory Bowel Diseases Center, Washington University in Saint Louis, St. Louis, MO, USA.

View Article and Full-Text PDF

The mutually complementary role of magnetic resonance enterography and conventional enteroclysis in patients with complicated and/or advanced stage of Crohn's disease.

Bratisl Lek Listy 2021 ;122(4):270-276

Aim: To assess the diagnostic significance of magnetic resonance enterography (MRE) and conventional enteroclysis (CE) in patients with complicated and/or advanced stage of Crohn's disease.

Methods: Patients with abnormal CE findings suggestive of mural and/or extramural involvement with the diagnosis or pre-diagnosis of CD are evaluated. After real-time bowel distension by enteroscopic examination, the patients with advanced or complicated stage were taken to the MRE examination in the same session. Read More

View Article and Full-Text PDF