P172 Postoperative recurrence of Crohn's disease: correlation between endoscopy and bowel ultrasound
J. Yebra Carmona*1, C. Suárez Ferrer1, J. Poza Cordón1, J. L. Rueda García1, J. Lucas Ramos1, I. Andaluz García1, E. Martín Arranz1, S. Gómez Senent1, M. D. Martín Arranz1, P. Mora Sanz1
1La Paz Hospital, Gastroenterology, Madrid, Spain
Postoperative Crohn’s disease recurrence (POR) is currently assessed by ileocolonoscopy. B-mode bowel sonography (US) is an alternative, non-invasive, non-ionising and well tolerated diagnostic method. Our aim was to validate US, and to establish a correlation between the different ultrasound parameters of activity and Rutgeerts endoscopic score
We selected 31 patients with Crohn’s disease in follow-up at our unit, who had underwent surgical ileocolic resection, which performed ileocolonoscopy and US for the diagnosis of POR, with a difference between both tests lesser than 6 months. Recurrence was assessed by ileocolonoscopy using the Rutgeerts score, considering: i0–i1 absence of recurrence; ≥i2 endoscopic recurrence. The echographic findings were bowel wall thickness (BWT), hyperaemia, layer pattern, involvement of the mesenteric fat, presence of adenopathy and transmural complications (fistulas and abscesess).
Clinical characteristics of the study population are reported in Table 1.
|Age at diagnosis||A1 2 (6,7%); A2 22 (73.3%); A3 6 (20%)|
|Disease location||L1 14 (45.2%); L2 0(0%); L3 17 (54.8%)|
|Illness behaviour at diagnosis||B1 3 (9.7%); B2 17(54.8%); B3 11 (35.5%)|
|Smoke habit||Smoker 9 (29%); ex-smoker 14 (45%); non-smoker 8 (26%)|
|Number of surgical resection||one: 27 (87%); two: 4 (13%)|
|Treatment||non 6(20%); azathioprine 5 (16%); anti-TNF 8 (26,7%); combined 11 (36%)|
|Rutgeerts score||io–i1: 11 (35.5%); i2: 10 (32%); i3–i4: 10 (32%)|
|Endoscopic recurrence||≥i2: 20 (64,5%)|
|Faecal calprotectin||>50 ng/mg: 18 (58%)|
Main demographic, clinical characteristics according to Montreal classification.
Ileoconoloscopy detected recurrence in 20 of 31 patients (64%). A statistically significant association was identified between wall thickness and recurrence (
ROC curve analysis
There is a good relationship between the different echographic parameters of activity (bowel thickness, hyperaemia, wall distortion, etc.) and the presence of endoscopic recurrence, as well as the severity of the recurrence.